Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker |
NPI | 1003488065 |
---|---|
Provider Name | Robsan Yusuf |
First Address | Minneapolis, MN 55454-1220 |
Second Address | Minneapolis, MN 55454-1220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2021 |
Last Update Date | 10/07/2021 |