Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0202X | Pediatric Cardiologist | 278892 | NY |
N | 2080P0202X | Pediatric Cardiologist | A162132 | CA |
N | 2080P0203X | Pediatric Critical Care Doctor | 036.140327 | IL |
Y | 2080P0203X | Pediatric Critical Care Doctor | 278892 | NY |
NPI | 1215279765 |
---|---|
Provider Name | Boran Li |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10029-6503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 10/08/2021 |