| NPI | 1336385707 |
|---|---|
| Former Name | MELINDA POWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 7201056-1206) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: UT 7201056-1205) |
| Enumeration Date | 2009-01-06 |
| Last Update Date | 2014-03-21 |