| NPI | 1215945894 |
|---|---|
| Former Name | KELSEY FAYE ANGELL MCEWEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MN 67200) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085003576) |
| 363A00000X Physician Assistant (Licence: WI 1746-023) | |
| Enumeration Date | 2006-08-03 |
| Last Update Date | 2023-03-07 |