| NPI | 1245886209 |
|---|---|
| Former Name | MELISA SUZANNE BERTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ME PA2037) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2023-08-11 |