| NPI | 1639481070 |
|---|---|
| Former Name | KERRI LYNN MICHELLA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NY 014031) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 014031) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2022-06-08 |