| NPI | 1982272126 |
|---|---|
| Former Name | KAYLIN MARISA JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TN 3864) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: PA 5500000174924909) |
| 152W00000X Optometrist (Licence: PA OEG003820) | |
| 152W00000X Optometrist (Licence: FL OPC6044) | |
| Enumeration Date | 2021-06-14 |
| Last Update Date | 2025-01-16 |