| NPI | 1275696866 |
|---|---|
| Former Name | THAO PHUONG TRAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: NM MD2018-0703) |
| Additional Taxonomies | 208D00000X General Practice (Licence: MN 48381) |
| 208C00000X Colon & Rectal Surgery (Licence: MO 2012029320) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2018-08-06 |