| NPI | 1023246873 |
|---|---|
| Former Name | JILL ANITA SANDBAKKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SD T681) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 002458) |
| Enumeration Date | 2009-06-30 |
| Last Update Date | 2023-09-26 |