Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 36825 | MN |
NPI | 1154376176 |
---|---|
Provider Name | Dr. Francis Xavier Moga |
First Address | Minneapolis, MN 55404-4291 |
Second Address | Minneapolis, MN 55404-4291 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/05/2006 |
Last Update Date | 17/05/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
921824600 | (05) | MN |
F96099 | (02) |