| NPI | 1447614300 |
|---|---|
| Former Name | KELSEY BRAGG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA 9109394) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MA PA8918) |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2023-04-05 |