NPI | 1114487691 |
---|---|
Former Name | KELSEY MARIE LENA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NC 2022-00739) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NC 250210) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2022-06-01 |