Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 0101272331 | VA |
NPI | 1578116661 |
---|---|
Provider Name | Dr. Daisuke Imai |
First Address | Richmond, VA 23298-0645 |
Second Address | Richmond, VA 23298-5025 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2019 |
Last Update Date | 11/02/2022 |