NPI | 1699401968 |
---|---|
Former Name | MCKELL KELLOGG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA2909) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2022-07-28 |
Last Update Date | 2023-12-11 |