| NPI | 1376898825 |
|---|---|
| Former Name | PHIMPHAO CHULASAWAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 14420) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: CA 14420) |
| 152WV0400X Optometrist, Vision Therapy (Licence: CA 14420) | |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2021-12-22 |