NPI | 1902354426 |
---|---|
Former Name | MELISSA PHIPPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058380) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: PA MA058380) |
Enumeration Date | 2016-09-13 |
Last Update Date | 2024-03-29 |