| NPI | 1710983655 |
|---|---|
| Former Name | MELINDA ANN MACKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO 3609) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 005406) |
| 363A00000X Physician Assistant (Licence: GA 005406) | |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2015-01-19 |