| NPI | 1861453086 |
|---|---|
| Former Name | SUSAN L CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: NV DO2860) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: NV B02003) |
| 111N00000X Chiropractor (Licence: ID CHIA-1251) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2021-07-29 |