Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | 04-35300 | KS |
N | 207RH0003X | Hematology & Oncology | 202325 | LA |
NPI | 1013172253 |
---|---|
Provider Name | Dr. Tara L Lin |
First Address | Westwood, KS 66205-2005 |
Second Address | Kansas City, KS 66160-8500 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2008 |
Last Update Date | 08/05/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1180025 | (05) | LA |