NPI | 1366896565 |
---|---|
Former Name | MELISSA ROSE MITCHELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL ME142757) |
Additional Taxonomies | 208D00000X General Practice (Licence: NY P00133) |
Enumeration Date | 2016-04-14 |
Last Update Date | 2024-09-27 |