NPI | 1821586991 |
---|---|
Former Name | DARAH KELLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: FL ME155260) |
Additional Taxonomies | 208000000X Pediatrics (Licence: OH 35.139795) |
Enumeration Date | 2018-04-24 |
Last Update Date | 2024-08-20 |