Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1100X | Ophthalmic | 169981 | WA |
NPI | 1225580285 |
---|---|
Provider Name | Ms. Di Wei |
First Address | Denver, CO 80236-3009 |
Second Address | Lone Tree, CO 80124-5425 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2016 |
Last Update Date | 25/10/2016 |