Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 23407 | NE |
N | 111NI0900X | Internist | 23407 | NE |
N | 207RH0000X | Hematologist | 53612 | MN |
Y | 207RX0202X | Medical Oncology | 53612 | MN |
NPI | 1245320282 |
---|---|
Provider Name | Kiran K Lassi |
First Address | Coon Rapids, MN 55433-2578 |
Second Address | Coon Rapids, MN 55433-2578 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 20/04/2016 |