| NPI | 1093152688 |
|---|---|
| Former Name | CHELSEY CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TN 2335) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: SC 3039) |
| Enumeration Date | 2013-05-23 |
| Last Update Date | 2020-09-10 |