| NPI | 1912360884 |
|---|---|
| Former Name | MELISSA RENE BALBUENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084N0600X (Licence: AZ 60389) |
| Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NY 310792-01) |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: TX T3923) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: AZ 60389) | |
| 2084N0400X Psychiatry & Neurology, Neurology (Licence: CO DR.0066884) | |
| 2084N0600X (Licence: MI 4301504544) | |
| 2084N0600X (Licence: CO DR.0066884) | |
| 2084N0600X (Licence: NY 310792-01) | |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2023-06-02 |