| NPI | 1023603842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GULED MOHAMOUD Manager 612-636-7337 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics Developmental - Behavioral Pediatrics |
| Enumeration Date | 2021-03-03 |
| Last Update Date | 2021-03-03 |