| NPI | 1063641579 |
|---|---|
| Former Name | MALACHIA CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: ND 12886) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 5984) |
| 208000000X Pediatrics (Licence: NE 5984) | |
| Enumeration Date | 2009-07-06 |
| Last Update Date | 2014-01-15 |