NPI | 1801132360 |
---|---|
Former Name | MELISSA SCHRAMM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IL 085.004553) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: IL 3734146) |
Enumeration Date | 2013-01-02 |
Last Update Date | 2016-01-22 |