| NPI | 1295338119 |
|---|---|
| Former Name | MELISSA ANN MCWATTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IL 085008746) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2020-11-21 |
| Last Update Date | 2024-01-03 |