Individual
MS. KHINE MIRA TIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
800 E 28TH ST # H2100, MINNEAPOLIS, MN 55407-3723
(612) 863-3963
Mailing address
920 E 28TH ST STE 300, MINNEAPOLIS, MN 55407-1195
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12983
MN
Other
Enumeration date
04/23/2019
Last updated
04/27/2022
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