| NPI | 1043492291 |
|---|---|
| Former Name | KELLY INGRID MACHEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TX N1166) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2010-05-21 |