| NPI | 1952890097 |
|---|---|
| Former Name | JENNA LACE BUCKLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OR 4660) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 33999) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2023-10-04 |