Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | DS037841 | PA |
NPI | 1073835005 |
---|---|
Provider Name | Dr. Kuo-Wei Lin |
First Address | Philadelphia, PA 19102 |
Second Address | Philadelphia, PA 19102 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/02/2010 |
Last Update Date | 18/12/2013 |