NPI | 1912345745 |
---|---|
Former Name | MELISSA BROOKE BAILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL 1996) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 006852) |
363AM0700X Physician Assistant, Medical (Licence: GA 006852) | |
Enumeration Date | 2013-06-14 |
Last Update Date | 2024-10-23 |