| NPI | 1912279647 | 
|---|---|
| Former Name | TANH HUU PHAN | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 33351)  | 
| Additional Taxonomies | 111NX0100X Chiropractor, Occupational Health (Licence: TX 11935)  | 
| Enumeration Date | 2012-01-26 | 
| Last Update Date | 2015-07-27 |