Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | LP03721 | RI |
Y | 207T00000X | Neurosurgeon | MD472960 | PA |
NPI | 1003158163 |
---|---|
Provider Name | Xun Li |
First Address | Philadelphia, PA 19107-6130 |
Second Address | Philadelphia, PA 19107-6130 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2013 |
Last Update Date | 03/06/2021 |