| NPI | 1477917532 |
|---|---|
| Former Name | KELLY ELIZABETH ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: WI 1530-230) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: AL 38387) |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2021-10-29 |