Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 1781-715T | LA |
NPI | 1003225905 |
---|---|
Provider Name | Ha Ninh |
First Address | New Orleans, LA 70121-2429 |
Second Address | Slidell, LA 70461-5544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2014 |
Last Update Date | 16/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00159832 | (05) | MS |
2375067 | (05) | LA |