| NPI | 1477582880 |
|---|---|
| Former Name | KELLY MARIE BOWLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MN 51737) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MO 2005017750- resident) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2018-09-24 |