Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 2017-00702 | NC |
NPI | 1518286061 |
---|---|
Provider Name | Leslie Horn Clark |
First Address | Chapel Hill, NC 27514-4220 |
Second Address | Chapel Hill, NC 27514-4220 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2010 |
Last Update Date | 21/08/2019 |