Individual
LI LI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
74 ROUTE 6A, SANDWICH, MA 02563-1864
(508) 833-1569
(508) 888-8936
Mailing address
74 ROUTE 6A, SANDWICH, MA 02563-1864
(508) 833-1569
(508) 888-8936
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2001001898
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200950608
—
MO
Enumeration date
06/07/2006
Last updated
06/26/2020
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