Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | 119-320 | WI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 66408 | MN |
NPI | 1023423290 |
---|---|
Provider Name | Luiz Fernando Leonavicius Guimaraes Franco |
First Address | Fargo, ND 58103-4940 |
Second Address | Duluth, MN 55805-1913 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2014 |
Last Update Date | 30/11/2021 |