Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0402X | Child Neurologist | 62896 | MN |
NPI | 1154607489 |
---|---|
Provider Name | Janet Elgallab |
First Address | Minneapolis, MN 55407-1544 |
Second Address | Minneapolis, MN 55407-1544 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2011 |
Last Update Date | 29/11/2017 |