| NPI | 1790280543 |
|---|---|
| Former Name | KELLI RENEE PRATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OH 34.015024) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2023-06-20 |