| NPI | 1386958650 |
|---|---|
| Former Name | MELISSA ANN UNDERWOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: KY 3007969) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: OH COA.11929-NP) |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2013-07-22 |