NPI | 1083170088 |
---|---|
Former Name | MELANIE R SHRONTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC296) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50.005717RX) |
363AM0700X Physician Assistant, Medical (Licence: KY TC296) | |
363AS0400X Physician Assistant, Surgical (Licence: KY TC296) | |
Enumeration Date | 2019-02-14 |
Last Update Date | 2022-09-20 |