| NPI | 1912932666 |
|---|---|
| Former Name | CLARISSA DAWN GLOVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: AZ 1682) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: AL S-A73-TA-641) |
| 152W00000X Optometrist (Licence: NC 2535) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2016-07-22 |