| NPI | 1790294684 |
|---|---|
| Former Name | KELLY BOYLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.006307) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: IL 085006307) |
| Enumeration Date | 2017-09-24 |
| Last Update Date | 2023-09-22 |