NPI | 1073928651 |
---|---|
Former Name | JENNIFER TRANG LE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 19031) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036141632) |
Enumeration Date | 2014-06-23 |
Last Update Date | 2019-08-30 |