| NPI | 1235463092 |
|---|---|
| Former Name | KELLE RAE HERNING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: VT 042.0015262) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60500534) |
| Enumeration Date | 2009-09-28 |
| Last Update Date | 2023-06-30 |