NPI | 1457723488 |
---|---|
Former Name | MICHELLE LYNN MEROLA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12997) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-005127) |
363A00000X Physician Assistant (Licence: DC PA031196) | |
Enumeration Date | 2015-10-29 |
Last Update Date | 2023-01-26 |