| NPI | 1881076164 |
|---|---|
| Former Name | KELLY KAY WISLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5101026667) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 5101022043) |
| 207V00000X Obstetrics & Gynecology (Licence: OK 6593) | |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-05-25 |