Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | NP19237 | CA |
NPI | 1093094161 |
---|---|
Provider Name | Grace Thuy Le |
First Address | San Jose, CA 95150-5280 |
Second Address | San Jose, CA 95128-2604 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 08/08/2011 |