Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 3940 | MN |
NPI | 1154427508 |
---|---|
Provider Name | Dr. Margaret M. Mitchell |
First Address | Edina, MN 55439-3120 |
Second Address | Edina, MN 55439-3120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2006 |
Last Update Date | 08/07/2007 |