NPI | 1548665607 |
---|---|
Former Name | CRYSTAL CHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014036835) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2014036835) |
363LF0000X Nurse Practitioner, Family (Licence: MO 2011005736) | |
Enumeration Date | 2014-10-30 |
Last Update Date | 2024-12-18 |