Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 67275 | MN |
NPI | 1235526336 |
---|---|
Provider Name | Nicholas Sausen |
First Address | New Orleans, LA 70118-5720 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2015 |
Last Update Date | 14/08/2020 |