| NPI | 1477860583 |
|---|---|
| Former Name | KELLY NICOLE KRAEMER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2084) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC 2084) |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2023-08-10 |