| NPI | 1841615754 |
|---|---|
| Former Name | KELLY CARMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 23036) |
| Additional Taxonomies | 208600000X Surgery (Licence: IL 036.150493) |
| 208600000X Surgery (Licence: ID O-1388) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2023-06-08 |