| NPI | 1437506425 |
|---|---|
| Former Name | KELLY MARIE COSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OH 35.136088) |
| Enumeration Date | 2016-05-19 |
| Last Update Date | 2025-07-07 |