Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | 60485837 | WA |
NPI | 1356514186 |
---|---|
Provider Name | Pamela Li |
First Address | Salt Lake City, UT 84125-0608 |
Second Address | Middleburg Heights, OH 44130-3417 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2008 |
Last Update Date | 18/12/2020 |