NPI | 1790787802 |
---|---|
Former Name | CUNG BUI PHAM |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A81143) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: MA 227004) |
Enumeration Date | 2005-06-01 |
Last Update Date | 2024-06-18 |