| NPI | 1679747216 |
|---|---|
| Former Name | BANG NGUYEN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CO DR.0054747) |
| Additional Taxonomies | 208D00000X General Practice (Licence: NE 13674) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2017-09-13 |