| NPI | 1265642656 |
|---|---|
| Former Name | PHUONG THAO THI PHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 37311) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OK 12509) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2007-07-08 |