| NPI | 1154382109 |
|---|---|
| Former Name | ELIZABETH NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MS 4087-19) |
| Additional Taxonomies | 122300000X Dentist (Licence: LA 5192) |
| 1223G0001X Dentist, General Practice (Licence: VA 0401416415) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2022-01-24 |