| NPI | 1457918997 |
|---|---|
| Former Name | SAMANTHA LYNN SHOBE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IN 18004175A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-05-21 |
| Last Update Date | 2019-08-14 |