Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | 04-32206 | KS |
Y | 2080P0203X | Pediatric Critical Care Doctor | 2006032143 | MO |
N | 2080P0203X | Pediatric Critical Care Doctor | K1508 | TX |
NPI | 1184686248 |
---|---|
Provider Name | Erica Anne Molitor-Kirsch |
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 | 04/04/2006 |
Last Update Date | 24/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
116189503 | (05) | TX |
G59579 | (02) |