NPI | 1932140381 |
---|---|
Former Name | MELODIE JOY ENEDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 005322) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 005322) |
363AM0700X Physician Assistant, Medical (Licence: NY 5322) | |
363AS0400X Physician Assistant, Surgical (Licence: NY 005322) | |
Enumeration Date | 2006-06-09 |
Last Update Date | 2023-03-21 |