| NPI | 1760824619 |
|---|---|
| Other Name | PAUL T KELLY |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN260150) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9226188) |
| Enumeration Date | 2013-07-19 |
| Last Update Date | 2021-01-08 |