Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YS0123X | Facial Plastic Surgeon | 0101246352 | VA |
NPI | 1164483517 |
---|---|
Provider Name | Trang T. Vo-Nguyen |
First Address | Chantilly, VA 20152-5917 |
Second Address | Chantilly, VA 20152-5917 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 26/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
469726000 | (05) | MN |
G73117 | (02) |