NPI | 1982122578 |
---|---|
Former Name | MERISSA MYERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: IN 10003916A) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: ID PA-2562) |
363A00000X Physician Assistant (Licence: WA 1155930) | |
363A00000X Physician Assistant (Licence: WA PA60902142) | |
Enumeration Date | 2017-09-02 |
Last Update Date | 2023-09-07 |