Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 30492 | MN |
Y | 2084N0402X | Child Neurologist | 28800 | MN |
NPI | 1104843002 |
---|---|
Provider Name | Frank J Ritter |
First Address | Saint Paul, MN 55102-2697 |
Second Address | Saint Paul, MN 55102-2697 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/07/2006 |
Last Update Date | 20/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
813773100 | (05) | MN |
C46842 | (02) |