| NPI | 1952922395 |
|---|---|
| Former Name | JENNIFER HUYNH FONGSAMOUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AZ RNP26394) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN61087160) |
| 163W00000X Registered Nurse (Licence: AZ 26394) | |
| 363L00000X Nurse Practitioner (Licence: WA AP61088873) | |
| Enumeration Date | 2020-04-27 |
| Last Update Date | 2024-04-09 |