NPI | 1689948507 |
---|---|
Former Name | CHARLENE S WONG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 52715) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR P164832) |
Enumeration Date | 2012-02-24 |
Last Update Date | 2023-07-05 |