Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | MT220708 | PA |
NPI | 1336650456 |
---|---|
Provider Name | Dr. Kim Choong Wen Ng |
First Address | Garnet Valley, PA 19060-1129 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2017 |
Last Update Date | 02/07/2020 |