| NPI | 1225654643 |
|---|---|
| Former Name | LAUREN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: OH OPT.006881) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: KY 2176DT) |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2023-01-06 |