Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 62324 | MN |
NPI | 1285926212 |
---|---|
Provider Name | Daniel James Miller |
First Address | St. Paul, MN 55101 |
Second Address | St. Paul, MN 55101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2011 |
Last Update Date | 17/03/2018 |