| NPI | 1619653995 |
|---|---|
| Former Name | KARSEN TAYLER HISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152W00000X Optometrist (Licence: IA 126421) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IL 046.011915) |
| Enumeration Date | 2023-06-22 |
| Last Update Date | 2024-09-23 |