| NPI | 1194891457 |
|---|---|
| Former Name | SHEALEEN BLUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 2936) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: MD TA1960) |
| 152W00000X Optometrist (Licence: DC OP1000097) | |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2021-05-04 |