| NPI | 1164496824 |
|---|---|
| Former Name | FAYOMA S CLARKE-CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 001261) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 001261) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2022-11-07 |