Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | 52409 | MN |
NPI | 1265699276 |
---|---|
Provider Name | Ronald Terrence Yee |
First Address | Stillwater, MN 55082-6040 |
Second Address | Stillwater, MN 55082-6040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2008 |
Last Update Date | 29/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
19682 | RESIDENT PERMIT (01) | MN |