| NPI | 1235834300 |
|---|---|
| Former Name | KELLY THI LE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA17256) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2023-10-16 |