| NPI | 1417250317 |
|---|---|
| Former Name | SUSAN WANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55931) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA16924) |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2024-06-06 |