Individual
MR. THAI N/A MAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2740 S JONES BLVD, LAS VEGAS, NV 89146-5398
(702) 248-8866
Mailing address
2740 S JONES BLVD, LAS VEGAS, NV 89146-5398
(702) 248-8866
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
867027
NV
Other
Enumeration date
05/12/2023
Last updated
05/12/2023
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