| NPI | 1710437140 |
|---|---|
| Former Name | KELSEY KORP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 6460) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 6460) |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2018-05-30 |