Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 51635 | MN |
N | 207ND0900X | Dermatopathologist | 51635 | MN |
NPI | 1013943505 |
---|---|
Provider Name | Karla Susan Rosenman |
First Address | Minneapolis, MN 55425-4516 |
Second Address | St Louis Park, MN 55416-2527 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 13/04/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I29629 | (02) |