NPI | 1578785879 |
---|---|
Former Name | SHARI CLARKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207N00000X Dermatology (Licence: NY 248308) |
Additional Taxonomies | 207N00000X Dermatology (Licence: PA MT184351) |
Enumeration Date | 2007-05-03 |
Last Update Date | 2022-06-04 |