NPI | 1730795527 |
---|---|
Former Name | MELANIE EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11353) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2020-09-17 |
Last Update Date | 2021-10-28 |