| NPI | 1518496504 |
|---|---|
| Former Name | KELSEY BLAIR HAUGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: CO 3438) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: OK 2931) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2022-06-28 |