Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 8600 | MN |
NPI | 1003439241 |
---|---|
Provider Name | Mary Elizabeth Amundson |
First Address | Sauk Rapids, MN 56379-4569 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2020 |
Last Update Date | 13/10/2021 |