NPI | 1710219456 |
---|---|
Former Name | MELISSA MICHELLE BURGET |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015714) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 015714) |
Enumeration Date | 2010-02-05 |
Last Update Date | 2019-07-15 |