| NPI | 1770057309 |
|---|---|
| Former Name | MYNGOC BRADSHAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 172V00000X Community Health Worker |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2024-10-30 |