| NPI | 1962711481 |
|---|---|
| Former Name | MELISSA CASILLAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9107076) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: FL PA9107076) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2018-09-10 |