| NPI | 1497029177 |
|---|---|
| Former Name | MELYSSA M JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA MD60969397) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD60969397) |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2021-04-07 |