NPI | 1043472640 |
---|---|
Former Name | PHU GIA PHAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MT192216) |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: PA MD439436) |
2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA A118484) | |
Enumeration Date | 2008-06-26 |
Last Update Date | 2021-10-18 |