Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 29106 | MN |
N | 2080P0214X | Pediatric Pulmonologist | 036.073387 | IL |
Y | 2080P0214X | Pediatric Pulmonologist | 29106 | MN |
NPI | 1154421642 |
---|---|
Provider Name | Gail M Brottman |
First Address | Minneapolis, MN 55415-0001 |
Second Address | Minneapolis, MN 55415-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2006 |
Last Update Date | 26/12/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F27078 | (02) |