NPI | 1083147862 |
---|---|
Former Name | KIET TUAN TRAN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME137806) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-04-07 |
Last Update Date | 2021-10-14 |