Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | OPC4617 | FL |
NPI | 1013296508 |
---|---|
Provider Name | Lanh Thi Nguyen |
First Address | Miramar, FL 33029-5149 |
Second Address | Hialeah, FL 33013-3848 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2011 |
Last Update Date | 26/09/2011 |