Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 52848 | MN |
NPI | 1124296918 |
---|---|
Provider Name | Rawad Tanios Nasr |
First Address | Bloomington, MN 55425-4516 |
Second Address | St Louis Park, MN 55416-2527 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2008 |
Last Update Date | 02/12/2021 |