| NPI | 1477117224 |
|---|---|
| Former Name | KELLY ANNE PASSABET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: CA A196007) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-26 |
| Last Update Date | 2024-07-09 |