| NPI | 1487267233 |
|---|---|
| Former Name | CHANSAMONE THEPMONTRY NHEP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: CA NP95015055) |
| Enumeration Date | 2020-08-30 |
| Last Update Date | 2021-10-29 |