| NPI | 1750654323 |
|---|---|
| Former Name | KELLY O'BRIEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA164512) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: OR PA164512) |
| 363A00000X Physician Assistant (Licence: OR PA164512) | |
| Enumeration Date | 2012-02-13 |
| Last Update Date | 2018-11-08 |