| NPI | 1629006010 |
|---|---|
| Former Name | MARY ANN E CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP008753) |
| Additional Taxonomies | 207RH0002X Internal Medicine, Hospice and Palliative Medicine (Licence: PA SP008753) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2016-06-10 |