Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | 4301074833 | MI |
NPI | 1275584799 |
---|---|
Provider Name | Feng Qing |
First Address | Royal Oak, MI 48073-6769 |
Second Address | Royal Oak, MI 48073-6769 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 08/07/2007 |