Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036129960 | IL |
N | 2086S0122X | Plastic and Reconstructive Surgery | MD60024722 | WA |
NPI | 1104931286 |
---|---|
Provider Name | Dr. Daniel Zhidi Liu |
First Address | Zion, IL 60099-2676 |
Second Address | Zion, IL 60099-2676 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 15/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
335110 | (02) | WA |