| NPI | 1477582880 | 
|---|---|
| Former Name | KELLY MARIE BOWLIN | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 51737)  | 
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 51737)  | 
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2005017750- resident)  | |
| Enumeration Date | 2006-06-30 | 
| Last Update Date | 2024-12-02 |