| NPI | 1134817653 |
|---|---|
| Former Name | JACQUELINE MAMIGO CHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: IL 041269945) |
| Enumeration Date | 2023-04-25 |
| Last Update Date | 2023-04-25 |