NPI | 1396279030 |
---|---|
Former Name | JACINTA PHUONG NGUYEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 86580) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: GA 049124073) |
Enumeration Date | 2017-04-19 |
Last Update Date | 2020-08-17 |