Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 69820 | MN |
N | 207R00000X | Internist | 30760 | MN |
N | 111NI0900X | Internist | 30760 | MN |
NPI | 1003436155 |
---|---|
Provider Name | Amira Elizabeth Joseph |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2020 |
Last Update Date | 25/08/2021 |