NPI | 1306125349 |
---|---|
Former Name | PHUONG THI KIM DUONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2011-08-09 |
Last Update Date | 2024-03-19 |