NPI | 1386811362 |
---|---|
Former Name | MARY NGUYEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0065882) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036122304) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2021-06-21 |