Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 46571 | MN |
NPI | 1003925652 |
---|---|
Provider Name | Guruprasad Ranganatha Rao Kaginele |
First Address | Rochester, MN 55901 |
Second Address | Faribault, MN 55021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G92785 | (02) |