| NPI | 1982833935 |
|---|---|
| Former Name | STEPHANIE ANN BENEDICT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MO 2023036387) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KS 1941) |
| Enumeration Date | 2009-07-13 |
| Last Update Date | 2024-02-20 |