| NPI | 1184903056 |
|---|---|
| Former Name | MEAGAN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY F382202) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 382202) |
| Enumeration Date | 2011-08-10 |
| Last Update Date | 2023-07-06 |