| NPI | 1447576376 |
|---|---|
| Former Name | CHRYSTIA JANEEN CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 58619) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2023-08-07 |