| NPI | 1447480488 |
|---|---|
| Former Name | THANH LAN PHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: RI DEN03059) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: TX 0024901) |
| Enumeration Date | 2009-07-24 |
| Last Update Date | 2009-10-07 |