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 |