NPI | 1538668140 |
---|---|
Former Name | MELISSA CLEMENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY TC980) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 088778) |
363A00000X Physician Assistant | |
Enumeration Date | 2018-02-09 |
Last Update Date | 2020-10-27 |