| NPI | 1609399427 |
|---|---|
| Former Name | VICTORIA CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00446600) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2025-02-25 |