NPI | 1740610203 |
---|---|
Former Name | JENNY VUONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9109392) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 001004534) |
Enumeration Date | 2013-11-20 |
Last Update Date | 2020-10-21 |