Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 40406 | KY |
NPI | 1003901208 |
---|---|
Provider Name | Michael Han Young |
First Address | Lexington, KY 40517-4012 |
Second Address | Lexington, KY 40536-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 12/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I33134 | (02) |