| NPI | 1871571554 |
|---|---|
| Former Name | DESHA KELLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MD D0062362) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MD D0062362) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2019-04-30 |