Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 11536R | LA |
N | 208600000X | Surgeon | 11536R | LA |
N | 208200000X | Surgeon | 35.125525 | OH |
N | 208600000X | Surgeon | 35.125525 | OH |
N | 2086X0206X | Surgical Oncologist | 11536R | LA |
Y | 2086X0206X | Surgical Oncologist | 35.125525 | OH |
NPI | 1235152844 |
---|---|
Provider Name | Benjamin Dunlop Li |
First Address | Cleveland, OH 44109-1900 |
Second Address | Cleveland, OH 44109-1900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F48796 | (02) | LA |