Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC007209 | PA |
NPI | 1053082644 |
---|---|
Provider Name | Nghi-Binh Ha Le |
First Address | Philadelphia, PA 19121-2242 |
Second Address | Philadelphia, PA 19118-2765 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/09/2021 |
Last Update Date | 23/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
SC007209 | LICENSE (01) | PA |