Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | 59917 | MN |
Y | 207RX0202X | Medical Oncology | 59917 | MN |
NPI | 1144557638 |
---|---|
Provider Name | Jasmine Kamboj |
First Address | Bemidji, MN 56601-6151 |
Second Address | Bemidji, MN 56601-6151 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/11/2009 |
Last Update Date | 23/11/2020 |