NPI | 1215432489 |
---|---|
Former Name | LEAH N CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: FL ME156208) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-03-28 |
Last Update Date | 2023-06-23 |