NPI | 1710122817 |
---|---|
Former Name | MELINDA AMELIA SANTIAGO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9117549) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 013030) |
Enumeration Date | 2008-12-04 |
Last Update Date | 2023-11-20 |