Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 48312 | MN |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 48312 | MN |
NPI | 1083806061 |
---|---|
Provider Name | Erin Amy Osterholm |
First Address | Minneapolis, MN 55455-0341 |
Second Address | Minneapolis, MN 55455-0363 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/08/2007 |
Last Update Date | 26/04/2016 |