NPI | 1336439785 |
---|---|
Former Name | NINA DIEM TRAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 61734) |
Additional Taxonomies | 122300000X Dentist (Licence: CA 61734) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2011-04-19 |
Last Update Date | 2019-07-18 |