Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0116029223 | VA |
NPI | 1003266552 |
---|---|
Provider Name | Thuy Phuong Thi Vo |
First Address | Fairfax, VA 22033-1710 |
Second Address | Fairfax, VA 22033-1710 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2016 |
Last Update Date | 15/06/2016 |