Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 60603 | AZ |
NPI | 1063754687 |
---|---|
Provider Name | Xiaoyi Li |
First Address | Mesa, AZ 85206-1749 |
Second Address | Mesa, AZ 85206-1749 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2013 |
Last Update Date | 03/09/2021 |