| NPI | 1609860634 |
|---|---|
| Former Name | MELISSA C GOERTEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 3112) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA051109) |
| 363AM0700X Physician Assistant Medical (Licence: PA MA051109) | |
| 363AS0400X Physician Assistant Surgical (Licence: PA MA051109) | |
| Enumeration Date | 2005-09-06 |
| Last Update Date | 2022-03-16 |