Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901005161 | MI |
NPI | 1003390113 |
---|---|
Provider Name | Lauren Michelle Yoon |
First Address | Vienna, VA 22182-3970 |
Second Address | Woodhaven, MI 48183-2246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2018 |
Last Update Date | 08/04/2021 |