Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 69818 | MN |
N | 207R00000X | Internist | 31506 | MN |
N | 111NI0900X | Internist | 31506 | MN |
NPI | 1033748884 |
---|---|
Provider Name | Nasro Abdinur Isaq |
First Address | Rochester, MN 55905-0002 |
Second Address | Rochester, MN 55905-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2020 |
Last Update Date | 25/08/2021 |