Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1639159551 |
---|---|
Provider Name | Dr. Patricia T Kelly |
First Address | Berkeley, CA 94708-1304 |
Second Address | Berkeley, CA 94708-1304 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2006 |
Last Update Date | 08/07/2007 |