NPI | 1437223708 |
---|---|
Former Name | TINA H WANG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: MA PA4586) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 23-011294) |
Enumeration Date | 2006-11-20 |
Last Update Date | 2023-03-07 |