| NPI | 1962675223 |
|---|---|
| Former Name | LISA THAO NGUYEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A111918) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AZ 47273) |
| 208000000X Pediatrics (Licence: CA A111918) | |
| 208000000X Pediatrics (Licence: AZ 47273) | |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2019-06-10 |