| NPI | 1689652257 |
|---|---|
| Former Name | KATHLEEN MARY KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MA 234800) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: VA 0101231564) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2026-02-12 |