NPI | 1528449246 |
---|---|
Former Name | KELSEY ALLYSE THOMSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152WP0200X Optometrist, Pediatrics (Licence: OH OPT.6434-THER) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 5090) |
Enumeration Date | 2015-06-18 |
Last Update Date | 2021-11-05 |