| NPI | 1902289754 | 
|---|---|
| Former Name | KA LUNG KONG | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP60577140) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WA RN60273550) | 
| Enumeration Date | 2015-06-29 | 
| Last Update Date | 2015-09-02 |