| 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 |