| NPI | 1366878357 |
|---|---|
| Former Name | CARISSA LYNNE MERRITT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10771325-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 016988-1) |
| Enumeration Date | 2013-09-23 |
| Last Update Date | 2020-05-26 |