NPI | 1275822447 |
---|---|
Former Name | ERINN ELIZABETH KELLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: OH 50.003542) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 1965) |
363AS0400X Physician Assistant, Surgical (Licence: TN 1965) | |
Enumeration Date | 2011-03-28 |
Last Update Date | 2021-07-22 |