NPI | 1790947596 |
---|---|
Former Name | MELISSA AUGUSTINE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 31065) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL31065) |
Enumeration Date | 2008-07-02 |
Last Update Date | 2024-02-27 |