| NPI | 1245462589 |
|---|---|
| Former Name | KELSEY ELIZABETH EJZAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: CT 2312) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2019-08-02 |