NPI | 1619397064 |
---|---|
Former Name | SARA JANE CLAWSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: ID M-14414) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2014-04-24 |
Last Update Date | 2018-12-14 |