| NPI | 1710278957 |
|---|---|
| Former Name | KELLY ROSE FERGUSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: NY 298638) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: PA OS017606) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 63054) | |
| Enumeration Date | 2011-04-21 |
| Last Update Date | 2019-06-04 |