| NPI | 1225228901 |
|---|---|
| Former Name | HEATHER JOLENE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: AZ 40282) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: AZ 80870) |
| 207X00000X Orthopaedic Surgery (Licence: UT 7621240-1205) | |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2024-03-11 |