Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 55992 | MN |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 55992 | MN |
NPI | 1437440849 |
---|---|
Provider Name | Alana Sasaki |
First Address | Saint Paul, MN 55114-1522 |
Second Address | Saint Paul, MN 55102-1062 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2011 |
Last Update Date | 17/09/2020 |