| NPI | 1053584086 |
|---|---|
| Former Name | KELLY ELEANOR MOULTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: CT 55918) |
| Additional Taxonomies | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: NY 246762) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2017-01-16 |