| 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 |