| NPI | 1508343112 |
|---|---|
| Former Name | KELLY MARIE BRAUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: IN 10004477A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9114151) |
| Enumeration Date | 2018-07-26 |
| Last Update Date | 2024-08-16 |