| NPI | 1043697733 |
|---|---|
| Former Name | CA COOC THONG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA60663336) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 52374) |
| 363A00000X Physician Assistant (Licence: WI 3511-23) | |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2021-05-18 |