NPI | 1700868999 |
---|---|
Former Name | MELANIE TARA MCROY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 61939) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MA 216983) |
Enumeration Date | 2005-11-15 |
Last Update Date | 2022-07-21 |