Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | 69245-20 | WI |
NPI | 1093296253 |
---|---|
Provider Name | Liqin Xu |
First Address | Milwaukee, WI 53226-3548 |
Second Address | Milwaukee, WI 53226-3548 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2018 |
Last Update Date | 26/08/2018 |