NPI | 1134335672 |
---|---|
Former Name | MELISSA PIERCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA22226) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: WA PA60086303) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2021-12-21 |