| NPI | 1023083292 |
|---|---|
| Former Name | MELISSA CORNES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 4904) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 010711-1) |
| 363A00000X Physician Assistant (Licence: CT 004904) | |
| 363AM0700X Physician Assistant, Medical (Licence: FL PA9104557) | |
| 363AS0400X Physician Assistant, Surgical (Licence: CT 4904) | |
| Enumeration Date | 2006-02-21 |
| Last Update Date | 2023-08-02 |