NPI | 1578900833 |
---|---|
Former Name | JENNY M WANG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A15011) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OT015198) |
Enumeration Date | 2013-05-28 |
Last Update Date | 2022-09-12 |