| NPI | 1699113738 |
|---|---|
| Former Name | KELLY MARIE BRADY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: MI 5101022412) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: IL 125062808) |
| Enumeration Date | 2013-06-11 |
| Last Update Date | 2016-07-12 |