| NPI | 1760077382 |
|---|---|
| Former Name | KELLY ANNE FROMMELT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008483) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 13628) |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2024-04-04 |