Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 36245 | MN |
NPI | 1225008527 |
---|---|
Provider Name | Julie Chu |
First Address | Roseville, MN 55113 |
Second Address | St Paul, MN 55102 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2006 |
Last Update Date | 04/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
726184500 | (05) | MN |
F75020 | (02) |