| NPI | 1851042204 |
|---|---|
| Former Name | JESSIE NICHOLE CHIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA DOL.OL.61433949) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-01-17 |
| Last Update Date | 2023-04-12 |