| NPI | 1184890956 |
|---|---|
| Former Name | KELLY L MCMENIMEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: AZ 53834) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 121818) |
| 207R00000X Internal Medicine (Licence: MN 57669) | |
| 208000000X Pediatrics (Licence: MA 250673) | |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2024-11-06 |