Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 62083 | MN |
NPI | 1013250836 |
---|---|
Provider Name | Mrs. Asmaa Ferdjallah |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-4518 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2013 |
Last Update Date | 09/08/2021 |