| NPI | 1548641426 |
|---|---|
| Other Name | JACKIE GONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: KY 56099) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: IL 12506782) |
| Enumeration Date | 2015-06-16 |
| Last Update Date | 2024-04-24 |