| NPI | 1497059943 |
|---|---|
| Former Name | JENIFER CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: NY F306895) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 683274) |
| Enumeration Date | 2010-12-26 |
| Last Update Date | 2016-10-10 |