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 | 2024-07-03 |