| NPI | 1720458144 |
|---|---|
| Former Name | SUZANNE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: GA RN252341) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN252341) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2015-09-29 |