| NPI | 1740370188 |
|---|---|
| Former Name | VONGPHETH LUANGPHAXAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207PP0204X Emergency Medicine, Pediatric Emergency Medicine (Licence: CO 48651) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WA MD00046618) |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2014-04-01 |