NPI | 1386039154 |
---|---|
Former Name | MELISSA RUTH SYMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: WA MD61185777) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2015-03-30 |
Last Update Date | 2023-01-31 |