| NPI | 1578810578 |
|---|---|
| Former Name | MELISSA KAY WHITEHEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: IN 10001995A) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006409) |
| Enumeration Date | 2012-08-08 |
| Last Update Date | 2021-02-23 |