| NPI | 1063075208 |
|---|---|
| Former Name | THEODORA LANANH TRAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TN 62749) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-04-14 |
| Last Update Date | 2023-12-12 |