| NPI | 1972558476 |
|---|---|
| Former Name | MELISSA CLINE LOOS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-05141) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-05141) |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2023-03-13 |