| NPI | 1063032571 |
|---|---|
| Former Name | CLARA FORMBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AL MD.44096) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: AL MD.44096) |
| Enumeration Date | 2020-04-24 |
| Last Update Date | 2026-05-06 |