| NPI | 1962744797 |
|---|---|
| Former Name | KELSIE LYNN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036144025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036144025) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2017-11-17 |