| NPI | 1437552726 |
|---|---|
| Former Name | WANCHI JASON SU |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: CA 950000551) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA NP95000551) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2020-11-12 |