Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 61959 | MN |
N | 208000000X | Pediatrician | ML60470210 | WA |
Y | 2080P0204X | Pediatric Emergency Doctor | 61959 | MN |
NPI | 1184043192 |
---|---|
Provider Name | Viviane Tchonang Leuche |
First Address | Saint Paul, MN 55102-2346 |
Second Address | Minneapolis, MN 55454-1450 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2014 |
Last Update Date | 10/09/2020 |