| NPI | 1659569820 |
|---|---|
| Former Name | LINDA CLARK MELVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: DE C5-0001084) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA050913) |
| Enumeration Date | 2007-10-12 |
| Last Update Date | 2019-01-02 |