Individual
SELENA LIAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1020 TIJERAS AVE NE STE 22, ALBUQUERQUE, NM 87106-4749
(505) 848-3124
Mailing address
1020 TIJERAS AVE NE STE 22, ALBUQUERQUE, NM 87106-4749
(505) 848-3124
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
MD2015-0542
NM
207Y00000X
Otolaryngology Physician
Primary
PG168875
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2010
Last updated
03/17/2018
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