Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 23788 | NE |
N | 208600000X | Surgeon | 23788 | NE |
Y | 2086X0206X | Surgical Oncologist | 23788 | NE |
NPI | 1174630917 |
---|---|
Provider Name | Quan P Ly |
First Address | Omaha, NE 68198-8102 |
Second Address | Omaha, NE 68198-8102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 31/01/2013 |