NPI | 1689135543 |
---|---|
Former Name | SOPHIE KATHERINE CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD61558159) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-03-25 |
Last Update Date | 2024-07-16 |