Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 4901005507 | MI |
NPI | 1013581321 |
---|---|
Provider Name | Mia Hill |
First Address | Dallas, TX 75320-8177 |
Second Address | Ann Arbor, MI 48104-1902 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2021 |
Last Update Date | 20/05/2021 |