Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 61059 | MN |
NPI | 1003293101 |
---|---|
Provider Name | Huiying Guo |
First Address | Minneapolis, MN 55425-1614 |
Second Address | Saint Paul, MN 55107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2015 |
Last Update Date | 29/08/2018 |