Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | ROO75031 | OK |
NPI | 1174677314 |
---|---|
Provider Name | Caitlin Trang Thi |
First Address | Oklahoma City, OK 73104 |
Second Address | Oklahoma City, OK 73104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2007 |
Last Update Date | 08/07/2007 |