| NPI | 1003291089 |
|---|---|
| Former Name | KELLY CHRISTINE SUMMERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: SC 2035) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: IN 18003922A) |
| Enumeration Date | 2015-07-20 |
| Last Update Date | 2022-02-07 |