| NPI | 1215550348 |
|---|---|
| Former Name | KELSIE NICOLE DIRKSING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006434RX) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-05-23 |
| Last Update Date | 2021-08-16 |