| NPI | 1558549634 |
|---|---|
| Former Name | ALISA MELTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: OK 31186) |
| Additional Taxonomies | 208600000X Surgery (Licence: GA 00-2040) |
| 2086S0102X Surgery, Surgical Critical Care (Licence: PA MD447864) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2021-12-08 |