NPI | 1336821586 |
---|---|
Former Name | JULIA ELIZABETH CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NJ 26NJ14891600) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: NJ 26NJ14891600) |
Enumeration Date | 2023-08-07 |
Last Update Date | 2023-09-27 |