| NPI | 1639106867 |
|---|---|
| Former Name | MELONY SUE SANDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 1039516) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 006919-1) |
| 363AS0400X Physician Assistant, Surgical (Licence: NY 006919-1) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2023-09-19 |