| 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 |