| NPI | 1962470864 |
|---|---|
| Former Name | REBECCA KAE MIKOLAJCZYK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AK 130799) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA 3061) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2018-10-17 |