Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 12827 | MN |
NPI | 1205303070 |
---|---|
Provider Name | Lindsay Rae Emmerich |
First Address | Edina, MN 55435-6027 |
Second Address | Edina, MN 55435-6027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2018 |
Last Update Date | 30/10/2018 |