Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 03-750 | AZ |
NPI | 1093080210 |
---|---|
Provider Name | Tue Minh Truong |
First Address | Gilbert, AZ 85234-2427 |
Second Address | Gilbert, AZ 85233-2900 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2012 |
Last Update Date | 21/03/2012 |