Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 23575 | WI |
N | 207RX0202X | Medical Oncology | 23575 | WI |
NPI | 1306932561 |
---|---|
Provider Name | Y Gregory Lin |
First Address | Marshfield, WI 54449-5777 |
Second Address | Marshfield, WI 54449 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
30363400 | (05) | WI |
B85033 | (02) |