Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | DR.0058940 | CO |
NPI | 1114284015 |
---|---|
Provider Name | Dr. Maxwell Yisheng Li |
First Address | Aurora, CO 80045-2581 |
Second Address | Longmont, CO 80501-2545 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2012 |
Last Update Date | 17/03/2018 |