| NPI | 1255564464 |
|---|---|
| Former Name | MELISSA MARIE CZAKO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 2309) |
| Enumeration Date | 2009-09-03 |
| Last Update Date | 2021-03-04 |