| NPI | 1114470648 |
|---|---|
| Former Name | ALYSSA SUE POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12247) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 3914-23) |
| Enumeration Date | 2016-08-02 |
| Last Update Date | 2022-07-21 |