| NPI | 1013210822 |
|---|---|
| Former Name | KELLY ANNE VANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: WV 17036) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 58-003772) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2010-12-16 |