NPI | 1184045783 |
---|---|
Former Name | HEATHER WONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ AP4838) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4838) |
Enumeration Date | 2013-12-27 |
Last Update Date | 2023-07-19 |