| NPI | 1871837872 |
|---|---|
| Former Name | MELISSA ELIZABETH HANSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 22711) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 22711) |
| 363AS0400X Physician Assistant, Surgical (Licence: CA 22711) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2023-05-11 |