| NPI | 1548735921 |
|---|---|
| Former Name | MAURA KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: DC RN1032039) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: VA 0024176514) |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2020-06-02 |