| NPI | 1619936309 |
|---|---|
| Former Name | LISA MICHELLE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: TN 10545) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000110187) |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2022-07-21 |