NPI | 1710909734 |
---|---|
Former Name | MELINDA BIGHAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9103553) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: FL PA9103553) |
Enumeration Date | 2006-07-25 |
Last Update Date | 2022-05-26 |