| NPI | 1538488101 |
|---|---|
| Former Name | BO R SONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA19789) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA19789) |
| Enumeration Date | 2010-05-21 |
| Last Update Date | 2025-01-16 |