Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | R813 | MN |
NPI | 1205506094 |
---|---|
Provider Name | Dr. Stephanie Rameh |
First Address | Falcon Heights, MN 55108-1123 |
Second Address | Minneapolis, MN 55455 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2021 |
Last Update Date | 14/09/2021 |