NPI | 1457385585 |
---|---|
Former Name | MELISSA KAYE THOMPSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 2171) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 520) |
Enumeration Date | 2006-07-11 |
Last Update Date | 2015-11-19 |