NPI | 1730376062 |
---|---|
Former Name | MELISSA TAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024170004) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 003688) |
Enumeration Date | 2007-10-01 |
Last Update Date | 2024-07-25 |