| NPI | 1245661487 |
|---|---|
| Former Name | CLAIRE MARIE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: LA PA.200680) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: LA 200680) |
| 363AM0700X Physician Assistant, Medical (Licence: TX PA08661) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2022-07-15 |