| NPI | 1093401200 |
|---|---|
| Former Name | KELLY ELIZABETH BAJOREK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: OH 57.255286) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-04-12 |
| Last Update Date | 2023-07-07 |