Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | AP135961 | TX |
NPI | 1043724867 |
---|---|
Provider Name | Trang Keung |
First Address | Plantation, FL 33322-4113 |
Second Address | Irving, TX 75039-2422 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2017 |
Last Update Date | 01/12/2017 |