Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 82732 | GA |
NPI | 1104185578 |
---|---|
Provider Name | Tiffany Wen-Zone Liang |
First Address | Atlanta, GA 30308-2212 |
Second Address | Atlanta, GA 30308-2212 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/05/2012 |
Last Update Date | 25/05/2019 |