| NPI | 1174751325 |
|---|---|
| Former Name | AMY BETH CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: WA MD61153930) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: IN 01068606A) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2009-06-26 |
| Last Update Date | 2021-06-10 |