| NPI | 1972069854 |
|---|---|
| Former Name | KELSEY HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13372) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: MN 13372) |
| Enumeration Date | 2019-02-15 |
| Last Update Date | 2022-07-27 |