Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 58338 | MN |
NPI | 1275707937 |
---|---|
Provider Name | Dr. Stephanie Ann Fritch Lilla |
First Address | Minneapolis, MN 55404-4518 |
Second Address | Minneapolis, MN 55404-4518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2008 |
Last Update Date | 09/12/2014 |