Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 39059 | KY |
Y | 207T00000X | Neurosurgeon | ME143543 | FL |
NPI | 1043203706 |
---|---|
Provider Name | Patrick Han |
First Address | Gainesville, FL 32610-3001 |
Second Address | Daytona Beach, FL 32114-2781 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2005 |
Last Update Date | 10/02/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200081060A | (05) | OK |
I14584 | (02) |