Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 66619 | MN |
NPI | 1043507577 |
---|---|
Provider Name | Yan Dong |
First Address | Duluth, MN 55802-2228 |
Second Address | Duluth, MN 55802-2228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2011 |
Last Update Date | 04/12/2020 |