| NPI | 1639449697 |
|---|---|
| Former Name | KELLY ELIZABETH GLEFFE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: SC 1710) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA08170) |
| Enumeration Date | 2012-01-09 |
| Last Update Date | 2024-02-02 |