NPI | 1821072380 |
---|---|
Former Name | KELLY ANN VOLMERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX PA00311) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX 1016844) |
Enumeration Date | 2005-11-30 |
Last Update Date | 2019-11-12 |