| NPI | 1083856496 |
|---|---|
| Former Name | MELISSA MARIE GRUNLOH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: IN 01076706A) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CO 50613) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2023-11-27 |