| NPI | 1003479254 |
|---|---|
| Former Name | KILEY K FAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: VA 0101281436) |
| Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: VA 0101281436) |
| Enumeration Date | 2019-04-15 |
| Last Update Date | 2026-02-16 |