Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 4301087332 | MI |
NPI | 1033230768 |
---|---|
Provider Name | Kakit Wong |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 01/03/2010 |