| NPI | 1982888194 |
|---|---|
| Former Name | MELISSA GONZALEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9115402) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 005222) |
| Enumeration Date | 2007-12-24 |
| Last Update Date | 2022-02-09 |