Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207SG0201X | Clinical Genetics (M.D.) | 70482 | MN |
NPI | 1336602184 |
---|---|
Provider Name | Faizal Zangwio Asumda |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-2789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/04/2019 |
Last Update Date | 22/11/2021 |