| NPI | 1164775136 |
|---|---|
| Former Name | DONNA ROSE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA056304) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018954) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2025-04-02 |