| NPI | 1417222829 |
|---|---|
| Former Name | MELISSA LYNNE PLOUVIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02049) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 018542) |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2017-10-19 |