| NPI | 1922499631 |
|---|---|
| Former Name | KELLY HUBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005681) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH AT.004376) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2021-09-22 |