Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | MD-44504 | IA |
N | 2086S0129X | Vascular Surgeon | MT197379 | PA |
NPI | 1144541681 |
---|---|
Provider Name | Jun Xu |
First Address | Iowa City, IA 52242-1009 |
Second Address | Iowa City, IA 52242-1009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2010 |
Last Update Date | 17/03/2018 |