NPI | 1013587666 |
---|---|
Former Name | KELLY DENISE SCHILLING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 61659) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2021-06-27 |
Last Update Date | 2023-07-10 |