Lili Tha

NPI #1114699428 in Frederick, Maryland

Provider Information

NPI Number: 1114699428
Entity Type: Individual
Name: Lili Tha
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Physician Assistant
Enumeration Date: Oct 5, 2021
Last Updated: Jan 19, 2023

Practice Location

Address: 300 BALLENGER CENTER DR
City: Frederick
State: Maryland
ZIP Code: 21703-7096
Phone: (866) 389-2727

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X
Physician Assistant	363A00000X	Primary

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