NPI | 1144560251 |
---|---|
Former Name | MELISSA CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MI 5101020321) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2013-02-26 |
Last Update Date | 2021-01-27 |