Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0208X | Pediatric Infectious Diseases | 109010 | MN |
Y | 2080P0208X | Pediatric Infectious Diseases | 61180 | MN |
NPI | 1679029581 |
---|---|
Provider Name | Dr. Nipunie Srimalie Rajapakse |
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 | 30/08/2016 |
Last Update Date | 19/08/2020 |