NPI | 1417238924 |
---|---|
Former Name | KRISTIN A CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR A003585) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR A03585) |
Enumeration Date | 2011-08-30 |
Last Update Date | 2021-12-28 |