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 |