| NPI | 1457651010 |
|---|---|
| Other Name | JACKIE RENTERIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: MA 5227) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OR 3561AT) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2022-07-21 |