| NPI | 1164125951 |
|---|---|
| Former Name | SAMANTHA YVONNE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT MED-RES-LIC-142042) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2024-12-23 |