| NPI | 1528578101 |
|---|---|
| Former Name | AMY JOY CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25875) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 23261) |
| Enumeration Date | 2017-10-09 |
| Last Update Date | 2022-08-18 |