| NPI | 1477109627 | 
|---|---|
| Former Name | THAO MINH DANG | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MA RN2274266) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: MA RN2274266) | 
| Enumeration Date | 2019-08-14 | 
| Last Update Date | 2025-03-07 |