NPI | 1366407405 |
---|---|
Former Name | FREDA EDWINA CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 600019) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 600019) |
Enumeration Date | 2006-04-20 |
Last Update Date | 2023-03-07 |