NPI | 1790829224 |
---|---|
Professional Name | ROZELLA REBECCA CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004163) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 5221) |
363A00000X Physician Assistant (Licence: NV PA1380) | |
Enumeration Date | 2007-02-17 |
Last Update Date | 2015-11-19 |