NPI | 1376530618 |
---|---|
Former Name | KRISTIN E LELVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME137481) |
Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: MI 079600) |
208100000X Physical Medicine & Rehabilitation (Licence: WI 52430) | |
Enumeration Date | 2005-10-03 |
Last Update Date | 2024-03-19 |