Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 0101226449 | VA |
NPI | 1164427175 |
---|---|
Provider Name | Ngoc Vu |
First Address | Herndon, VA 20170-4833 |
Second Address | Herndon, VA 20170-4833 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2005 |
Last Update Date | 08/07/2007 |