| NPI | 1376114017 |
|---|---|
| Former Name | CYNTHIA JUNE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 209025457) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MO 2022005931) |
| Enumeration Date | 2021-07-04 |
| Last Update Date | 2022-09-30 |