| NPI | 1932583291 |
|---|---|
| Other Name | JACKIE NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: LA PA.200859) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: LA PA.200859) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2023-05-22 |