Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0102X | Surgical Critical Care | 34.011751 | OH |
NPI | 1073755294 |
---|---|
Provider Name | Thanh Van Nguyen |
First Address | Dublin, OH 43016-4141 |
Second Address | Columbus, OH 43215-4701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2009 |
Last Update Date | 26/06/2019 |