Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 0101241645 | VA |
NPI | 1003023706 |
---|---|
Provider Name | Van-Anh Thi Nguyen |
First Address | Annandale, VA 22003-3013 |
Second Address | Annandale, VA 22003-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2007 |
Last Update Date | 17/03/2018 |