NPI | 1316323595 |
---|---|
Former Name | JOANNE ELAINE MELSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA10070) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2015-08-10 |
Last Update Date | 2022-08-19 |