Individual
MR. MICHAEL ANTHONY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
741297
CA
163WC0400X
Case Management Registered Nurse
RN 199634
OH
163WE0003X
Emergency Registered Nurse
741297
CA
163WG0000X
General Practice Registered Nurse
Primary
741297
CA
Other
Enumeration date
01/31/2007
Last updated
06/29/2012
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