| NPI | 1093153041 |
|---|---|
| Former Name | ANDREA MELISSA DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NC 2016-01755) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 191547) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2019-01-18 |