Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | J9243 | TX |
NPI | 1154381077 |
---|---|
Provider Name | Trang H Nguyen |
First Address | Milford, OH 45150-1483 |
Second Address | Milford, OH 45150-1483 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 10/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
124887403 | (05) | TX |
F94462 | (02) |