Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | ME127458 | FL |
NPI | 1013222058 |
---|---|
Provider Name | Dr. Lijian Wang |
First Address | Lakeland, FL 33805-3019 |
Second Address | Lakeland, FL 33805-3019 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2010 |
Last Update Date | 13/10/2021 |