Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 75964 | GA |
N | 207KA0200X | Allergist | 75964 | GA |
NPI | 1023225190 |
---|---|
Provider Name | Li Zuo |
First Address | Duluth, GA 30096-3243 |
Second Address | Duluth, GA 30096-5142 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2007 |
Last Update Date | 28/07/2021 |