| NPI | 1316576085 |
|---|---|
| Former Name | KELLY LORRAINE GRIMES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX V8408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OK 35930) |
| Enumeration Date | 2020-04-05 |
| Last Update Date | 2025-09-09 |