| NPI | 1407261522 |
|---|---|
| Former Name | ANNA-MARIA A CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: CO DR.0061777) |
| Additional Taxonomies | 208600000X Surgery (Licence: SC LL36893) |
| 2085R0001X (Licence: NM MD2024-0260) | |
| 2085R0001X (Licence: WI 66208-20) | |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2025-05-28 |