Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 55321 | KY |
NPI | 1104289446 |
---|---|
Provider Name | Yali Tu |
First Address | Lexington, KY 40503-2954 |
Second Address | Lexington, KY 40503-2954 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2016 |
Last Update Date | 26/08/2021 |