| NPI | 1902854128 |
|---|---|
| Former Name | MELISSA A CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50-00-2071) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OH 50-002071) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-09-16 |