NPI | 1407261522 |
---|---|
Former Name | ANNA-MARIA A CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO DR.0061777) |
Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: WI 66208-20) |
208600000X Surgery (Licence: SC LL36893) | |
Enumeration Date | 2014-06-26 |
Last Update Date | 2023-03-06 |