| NPI | 1982952537 |
|---|---|
| Former Name | KATELYN LOUISE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: FL OPC4759) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: SC 1723) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2014-06-02 |