NPI | 1902293756 |
---|---|
Former Name | CAROLINE MARIE MELROSE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: WA PA61116968) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
363A00000X Physician Assistant (Licence: WA PA61116968) | |
363A00000X Physician Assistant | |
363A00000X Physician Assistant | |
363A00000X Physician Assistant (Licence: ID PA-2010) | |
363AM0700X Physician Assistant, Medical (Licence: ID PA-2010) | |
363AS0400X Physician Assistant, Surgical (Licence: ID PA-2010) | |
Enumeration Date | 2015-04-20 |
Last Update Date | 2024-01-03 |