| NPI | 1992192579 |
|---|---|
| Former Name | AMANDA WONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60845015) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 207Q00000X Family Medicine (Licence: CA A144999) | |
| Enumeration Date | 2015-04-21 |
| Last Update Date | 2019-12-06 |