NPI | 1225548449 |
---|---|
Former Name | KELLY MICHELLE COLEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 8657) |
Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: GA 8657) |
Enumeration Date | 2017-10-02 |
Last Update Date | 2024-07-30 |