| NPI | 1902345929 |
|---|---|
| Former Name | MICHELLE RIEGO MENDOZA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CA 33623) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: HI 1003) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2023-12-20 |