NPI | 1649750266 |
---|---|
Former Name | NINA CHAN THACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA 61329804) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-08-14 |
Last Update Date | 2023-06-15 |