NPI | 1649588914 |
---|---|
Former Name | MELISSA N LIND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4250) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 085003857) |
Enumeration Date | 2010-09-20 |
Last Update Date | 2018-03-17 |