Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD60535104 | WA |
N | 2086S0129X | Vascular Surgeon | R72267 | AZ |
NPI | 1043524481 |
---|---|
Provider Name | Dr. Luke Xiaoli Zhan |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99204-2349 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 30/04/2021 |