Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 0101263588 | VA |
N | 207RP1001X | Pulmonary Disease | 0101263588 | VA |
NPI | 1033553664 |
---|---|
Provider Name | Xian Qiao |
First Address | Norfolk, VA 23507-1904 |
Second Address | Norfolk, VA 23507-1904 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2013 |
Last Update Date | 18/08/2021 |