| NPI | 1942738943 |
|---|---|
| Former Name | SOPHAVY SUON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX PA19411) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: CA 54512) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2025-09-16 |