NPI | 1225525017 |
---|---|
Former Name | KENDRA MARIE KELLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 308091) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 69028) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-04-17 |
Last Update Date | 2022-04-27 |