| NPI | 1740812502 |
|---|---|
| Former Name | JENNIFER JOAN TANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IL 209.019384) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: IL 041.334334) |
| Enumeration Date | 2020-02-10 |
| Last Update Date | 2024-01-23 |