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Individual
QI SUN
Active
Individual
QI SUN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
29592
MN
2084P0800X
Psychiatry Physician
Primary
309799
NY
2084P0800X
Psychiatry Physician
309799-01
NY
2084P0800X
Psychiatry Physician
65940
MN
Other
Enumeration date
05/11/2018
Last updated
09/02/2024
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