| NPI | 1124762653 |
|---|---|
| Former Name | MELISSA COURTNEY PELLMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI 4351051641) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO TL.0009293) |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2024-09-30 |