Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 60741 | MN |
Y | 2080P0208X | Pediatric Infectious Diseases | MT218079 | PA |
NPI | 1164801742 |
---|---|
Provider Name | Dr. Yasaman Fatemi |
First Address | Rochester, MN 55905-0001 |
Second Address | Philadelphia, PA 19104-4319 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2015 |
Last Update Date | 26/06/2019 |