| NPI | 1144894759 |
|---|---|
| Former Name | KELLY SUZANNE PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: MN 71988) |
| Additional Taxonomies | 208800000X Urology (Licence: MN 31552) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2022-08-11 |