NPI | 1083233464 |
---|---|
Former Name | MELISSA STAGG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: PA MD484796) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-04-15 |
Last Update Date | 2024-06-18 |