NPI | 1528570892 |
---|---|
Former Name | KELLY LOUVIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 3405) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 327683) |
Enumeration Date | 2017-10-26 |
Last Update Date | 2025-04-24 |