| NPI | 1790233013 |
|---|---|
| Former Name | KELLY MICHELLE KALAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 902496) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN F0916635) |
| Enumeration Date | 2016-09-15 |
| Last Update Date | 2023-11-27 |