Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | R-11209 | IA |
NPI | 1336629542 |
---|---|
Provider Name | Dr. Benjamin Yit Wei Jong |
First Address | Winnipeg, MANITOBA R3L 0S5 |
Second Address | Winnipeg, MANITOBA R3M 3E4 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/08/2018 |
Last Update Date | 23/07/2019 |