| NPI | 1871757492 |
|---|---|
| Former Name | AMY JENNIFER SPARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NE 1358) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IA 002428) |
| Enumeration Date | 2008-07-13 |
| Last Update Date | 2020-12-11 |