| NPI | 1306251509 |
|---|---|
| Former Name | THANH TAN NGUYEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OP61088631) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX BP10050257) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2024-07-26 |