| NPI | 1003046087 |
|---|---|
| Former Name | KRYSTAL ANN CHRISTENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1342) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 002462) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2021-09-09 |