Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | 85152 | GA |
NPI | 1083053912 |
---|---|
Provider Name | Khoi Nguyen |
First Address | Atlanta, GA 30342-3283 |
Second Address | Atlanta, GA 30342-3283 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2013 |
Last Update Date | 25/06/2021 |