Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 0435820 | KS |
NPI | 1356342943 |
---|---|
Provider Name | Mr. Perry Y Lin |
First Address | Saint Louis, MO 63150-5262 |
Second Address | Coffeyville, KS 67337 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 07/04/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G17977 | (02) |