NPI | 1598118572 |
---|---|
Other Name | JENNIFER ROSE CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.145559) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MD474160) |
207R00000X Internal Medicine (Licence: IN 11018950A) | |
Enumeration Date | 2016-07-14 |
Last Update Date | 2024-01-23 |