NPI | 1235699661 |
---|---|
Former Name | JESSICA KINYEN LI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0101278496) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: SC LL82587) |
Enumeration Date | 2019-03-21 |
Last Update Date | 2023-06-09 |