| NPI | 1336894450 |
|---|---|
| Former Name | KELLY HARDY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: TX 207268) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX 207268) |
| Enumeration Date | 2022-02-16 |
| Last Update Date | 2023-01-19 |