NPI | 1619974565 |
---|---|
Former Name | MELINDA M HENDRICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50001552) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: OH 50001552) |
Enumeration Date | 2005-07-07 |
Last Update Date | 2023-11-03 |