| NPI | 1003936857 |
|---|---|
| Former Name | KELLY ANN STAUDE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WI 40256) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 40256) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2021-05-27 |