NPI | 1831693779 |
---|---|
Former Name | BRETT AARON CLARK |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207VE0102X Obstetrics & Gynecology, Reproductive Endocrinology (Licence: CA A166780) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
207V00000X Obstetrics & Gynecology (Licence: CA A166780) | |
Enumeration Date | 2018-03-23 |
Last Update Date | 2022-08-05 |