Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0106X | Orthopaedic Hand Surgeon | 36753 | MN |
NPI | 1316924103 |
---|---|
Provider Name | Thomas M Walsh |
First Address | St Louis Park, MN 55426-5000 |
Second Address | St Louis Park, MN 55426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 17/12/2018 |