Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 67988 | MN |
NPI | 1770992331 |
---|---|
Provider Name | Shanthi Balani |
First Address | Minneapolis, MN 55454-1404 |
Second Address | Minneapolis, MN 55454-1404 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2014 |
Last Update Date | 11/09/2020 |