| NPI | 1881057826 |
|---|---|
| Former Name | KELLEY CROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: TN TN61249) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT212627) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2020-07-21 |