| NPI | 1194423582 |
|---|---|
| Former Name | CHASITY NICOLE MANKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 156FX1800X Technician/Technologist, Optician (Licence: OH 013501-SC) |
| Enumeration Date | 2023-02-16 |
| Last Update Date | 2023-02-16 |