| NPI | 1326296435 |
|---|---|
| Former Name | MAUREEN BANZUELA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14562) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: NY TUV-007333-1) |
| 152W00000X Optometrist (Licence: AZ 1798) | |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2012-12-28 |