| NPI | 1841474020 |
|---|---|
| Former Name | KELLY MICHELLE MCDONALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 062571) |
| Additional Taxonomies | 208600000X Surgery (Licence: VA 0101253473) |
| 208600000X Surgery (Licence: MD D0084668) | |
| 208600000X Surgery (Licence: DC MD045780) | |
| Enumeration Date | 2007-12-23 |
| Last Update Date | 2021-06-01 |