NPI | 1013451962 |
---|---|
Former Name | MELISSA ANN DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0402X Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology (Licence: UT 10714522-1205) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10714522-1205) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2016-12-12 |
Last Update Date | 2022-06-10 |