NPI | 1740096197 |
---|---|
Former Name | MELADY ELIZABETH ROMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11036719) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL 11036719) |
Enumeration Date | 2024-12-09 |
Last Update Date | 2025-09-04 |