Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | 27589 | MN |
NPI | 1043262629 |
---|---|
Provider Name | Peter Brown Alden |
First Address | Minneapolis, MN 55407-1321 |
Second Address | Minneapolis, MN 55407-1139 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/05/2006 |
Last Update Date | 15/11/2011 |