| NPI | 1184392086 |
|---|---|
| Former Name | MEGAN NICOLE MELLON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA062711) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00656700) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2024-06-10 |