NPI | 1104046697 |
---|---|
Former Name | HUE THUC PHUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA05321) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: TX PA05321) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2019-05-20 |