Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 61658 | MN |
NPI | 1407174790 |
---|---|
Provider Name | Catherine Y Choi |
First Address | Woodbury, MN 55125-4925 |
Second Address | Vadnais Heights, MN 55127-7135 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2010 |
Last Update Date | 18/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036.123576 | LICENSE (01) | IL |
61658 | LICENSE (01) | MN |