NPI | 1609177674 |
---|---|
Former Name | MELISSA DALE LEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: ND R34298) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ND A) |
163W00000X Registered Nurse (Licence: MN R-198861-3) | |
Enumeration Date | 2010-11-08 |
Last Update Date | 2022-09-30 |