| NPI | 1528115755 |
|---|---|
| Former Name | MELISSA A BOTTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP112666) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 657825) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2021-11-09 |