Individual
KELLEY BOHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036.157398
IL
207W00000X
Ophthalmology Physician
332035
NY
Other
Enumeration date
03/22/2016
Last updated
08/06/2024
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