| NPI | 1427626415 |
|---|---|
| Former Name | KELLY MAGRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 172A00000X Driver | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2021-09-09 |