| NPI | 1124460373 |
|---|---|
| Former Name | ANNA L. CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ID NP-1356A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-36973) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2015-12-21 |