NPI | 1821292590 |
---|---|
Former Name | MELISSA C REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: AZ 6352) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: VA 0102202751) |
Enumeration Date | 2007-06-14 |
Last Update Date | 2015-07-07 |