NPI | 1013479054 |
---|---|
Former Name | NANCY TRAN PHAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: NV 1108) |
Additional Taxonomies | 152W00000X Optometrist (Licence: TX 9807) |
152W00000X Optometrist (Licence: AL R-283-TA-B89) | |
Enumeration Date | 2019-04-01 |
Last Update Date | 2021-11-02 |