Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207U00000X | Nuclear Medicine Specialist | IL | |
N | 207U00000X | Nuclear Medicine Specialist | 28516 | WI |
N | 207U00000X | Nuclear Medicine Specialist | 7829 | HI |
NPI | 1568558617 |
---|---|
Provider Name | Mukund Gai |
First Address | Champaign, IL 61822-7663 |
Second Address | Danville, IL 61832-5100 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |