NPI | 1972023646 |
---|---|
Former Name | ARIEL MARION JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NC 2523) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MO 2017017413) |
152WC0802X Optometrist Corneal and Contact Management (Licence: MO 2017017413) | |
Enumeration Date | 2017-06-23 |
Last Update Date | 2023-02-17 |