NPI | 1538715057 |
---|---|
Former Name | TIA GIALUONG LA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00831300) |
Additional Taxonomies | 363A00000X Physician Assistant |
363A00000X Physician Assistant (Licence: OH 50.008686RX) | |
363A00000X Physician Assistant (Licence: NY 031788-01) | |
363AM0700X Physician Assistant, Medical (Licence: PA MA063818) | |
363AM0700X Physician Assistant, Medical (Licence: PA OA006188) | |
Enumeration Date | 2019-08-12 |
Last Update Date | 2024-09-26 |