| NPI | 1043709066 |
|---|---|
| Former Name | KELLEY BURCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: VA 0102205885) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0102205885) |
| 208D00000X General Practice (Licence: VA 0102205885) | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2024-11-19 |