| NPI | 1689725566 |
|---|---|
| Former Name | HAE JEONG JO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA R.N. 482413) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 15836) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2020-05-05 |