| NPI | 1578911186 |
|---|---|
| Former Name | CASSIDY MICHELLE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: TX AP129906) |
| Enumeration Date | 2016-05-25 |
| Last Update Date | 2016-05-25 |