Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 2952000573 | MI |
NPI | 1588900518 |
---|---|
Provider Name | Dr. Chia-Cheng Li |
First Address | Ann Arbor, MI 48109-1078 |
Second Address | Ann Arbor, MI 48109-1078 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2012 |
Last Update Date | 13/06/2019 |