NPI | 1184910556 |
---|---|
Former Name | MELISSA LYNNE THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA OS016310) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT013944) |
Enumeration Date | 2011-06-23 |
Last Update Date | 2015-07-14 |