NPI | 1609185339 |
---|---|
Former Name | MELISSA LOUISE GARRETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 2316) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 511) |
Enumeration Date | 2010-09-29 |
Last Update Date | 2022-05-04 |