Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | 57060 | MN |
NPI | 1013975390 |
---|---|
Provider Name | Erica N. Roberson |
First Address | Minneapolis, MN 55414-0909 |
Second Address | Plymouth, MN 55446-3399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2006 |
Last Update Date | 18/03/2014 |