NPI | 1033628581 |
---|---|
Former Name | MELISSA REBECCA JAMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11130) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7553) |
Enumeration Date | 2017-09-28 |
Last Update Date | 2025-01-29 |