Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207SG0201X | Clinical Genetics (M.D.) | 0101265122 | VA |
Y | 208000000X | Pediatrician | 12879 | SD |
NPI | 1285021774 |
---|---|
Provider Name | Rachel Li |
First Address | Sioux Falls, SD 57117-5074 |
Second Address | Sioux Falls, SD 57105-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2015 |
Last Update Date | 25/01/2022 |