| NPI | 1477805703 |
|---|---|
| Former Name | DUYAN PHAM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 152WC0802X Optometrist, Corneal and Contact Management (Licence: WA OD60566357) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: WA OD60566357) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2020-02-11 |