| NPI | 1780114710 |
|---|---|
| Former Name | KELLY LYNN FISCHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2770) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2022-01-04 |