Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0201X | Pediatric Allergist | 31927 | SC |
NPI | 1902030042 |
---|---|
Provider Name | Dr. Kelli Wong Williams |
First Address | Charlotte, NC 28260-2108 |
Second Address | Charleston, SC 29414-5879 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2009 |
Last Update Date | 22/04/2020 |