NPI | 1497991566 |
---|---|
Professional Name | JACK CHAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 15505) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 577720) |
163WH0200X Registered Nurse, Home Health (Licence: CA 63642) | |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CA 15505) | |
Enumeration Date | 2008-12-19 |
Last Update Date | 2008-12-19 |