| NPI | 1558638874 |
|---|---|
| Former Name | KELLY E MICHAELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DC PA030863) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110003728) |
| Enumeration Date | 2011-12-01 |
| Last Update Date | 2018-07-10 |