| NPI | 1154373157 |
|---|---|
| Former Name | XIN GARY GONG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology (Licence: CT 056776) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: MD D61497) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2022-08-30 |