| NPI | 1740648880 |
|---|---|
| Former Name | BRANDIE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP8454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AZ RN164322) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2024-05-11 |