NPI | 1609844562 |
---|---|
Former Name | MELISSA LYNN MARTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AL 1-081366) |
Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: FL 9200085) |
Enumeration Date | 2006-03-08 |
Last Update Date | 2024-08-28 |