| NPI | 1487799334 |
|---|---|
| Former Name | AI-LIEN NGOC NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 122300000X Dentist (Licence: WA DE00008007) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WA DE8007) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2025-01-28 |