| NPI | 1780259192 |
|---|---|
| Other Name | KIEU PHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-02552) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 15-02552) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-05-26 |
| Last Update Date | 2022-09-08 |