NPI | 1891140471 |
---|---|
Former Name | KELLEY MICHELLE NAUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2021-03215) |
Additional Taxonomies | 208000000X Pediatrics (Licence: FL ME138706) |
Enumeration Date | 2016-05-02 |
Last Update Date | 2022-03-29 |