| NPI | 1730757105 |
|---|---|
| Former Name | JACQUELYN NICOLE BROWN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: VA 0618003035) |
| Additional Taxonomies | 152WP0200X Optometrist, Pediatrics (Licence: VA 0618003035) |
| 152WX0102X Optometrist, Occupational Vision (Licence: VA 0618003035) | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2023-12-20 |