Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | R76088 | AZ |
Y | 208600000X | Surgeon | R76088 | AZ |
NPI | 1013441112 |
---|---|
Provider Name | Bo Zhang |
First Address | Tucson, AZ 85724-5058 |
Second Address | Tucson, AZ 85724-5058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2017 |
Last Update Date | 14/04/2017 |