| NPI | 1265010763 |
|---|---|
| Former Name | MIMI PHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX W2724) |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2026-02-20 |