| NPI | 1003816505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FOLEY Administrator 612-813-3324 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0214X Pediatrics, Pediatric Pulmonology (Licence: MN 62826) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MN 62826) |
| Enumeration Date | 2005-07-26 |
| Last Update Date | 2017-09-01 |