| NPI | 1427587245 |
|---|---|
| Former Name | KELSEY BLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: TN 62062) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: SC 40924) |
| 208M00000X Hospitalist (Licence: TN 272824) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2022-08-03 |