| NPI | 1154618106 |
|---|---|
| Other Name | MATT G CLARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2080P0203X Pediatrics Pediatric Critical Care Medicine (Licence: AL MD.37170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL MD.37170) |
| 2080P0202X Pediatrics Pediatric Cardiology (Licence: AL MD.37170) | |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2020-10-07 |