NPI | 1114189164 |
---|---|
Former Name | MELISSA J MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: ME PA255) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA1133) |
363A00000X Physician Assistant (Licence: ME PA255) | |
Enumeration Date | 2008-07-01 |
Last Update Date | 2023-07-03 |