NPI | 1114239100 |
---|---|
Former Name | MELISSA FORBES ALLEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA07478) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 1535) |
363AM0700X Physician Assistant, Medical (Licence: SC TL1535) | |
Enumeration Date | 2010-07-08 |
Last Update Date | 2019-10-10 |