| NPI | 1902235146 |
|---|---|
| Former Name | KELLY DAVIS PUPELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 299323) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: FL PT 28657) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL 3707) | |
| Enumeration Date | 2013-11-07 |
| Last Update Date | 2023-07-12 |