| NPI | 1659343150 |
|---|---|
| Former Name | ELISA CHRISTINE KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: WA MD60318451) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: NC 9901444) |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NC 9901444) | |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2013-03-04 |