| NPI | 1811036338 |
|---|---|
| Former Name | KATHLEEN THUC-ANH PHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CA 55472) |
| Additional Taxonomies | 122300000X Dentist (Licence: NE 6565) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2012-11-05 |