| NPI | 1588156889 |
|---|---|
| Former Name | MATTIE MELISSA HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: AZ 62164) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AZ R77007) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2021-06-30 |