| NPI | 1760619357 |
|---|---|
| Former Name | DANA MARIE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: OR MD209098) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: FL ME119316) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2023-10-19 |