| NPI | 1023101920 |
|---|---|
| Former Name | LISA MARIE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: NM 621) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: CA 13010TPA) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2026-03-11 |