Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 04-30511 | KS |
NPI | 1033293410 |
---|---|
Provider Name | Taijun Zhao |
First Address | Topeka, KS 66606-1670 |
Second Address | Topeka, KS 66606-1670 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2006 |
Last Update Date | 22/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I10518 | (02) |