NPI | 1912147059 |
---|---|
Former Name | MELISSA MCCARTNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 2612) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NH 0701) |
Enumeration Date | 2009-03-03 |
Last Update Date | 2011-12-02 |