Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 0101251900 | VA |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 0101251900 | VA |
Y | 207RH0002X | Hospice and Palliative Medicine | 70275 | MN |
NPI | 1225267651 |
---|---|
Provider Name | Masoumeh Kiamanesh |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2009 |
Last Update Date | 05/10/2021 |