| NPI | 1659905156 |
|---|---|
| Former Name | KELLY CHRISTINE JEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601010584) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA57791) |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2022-07-21 |