| NPI | 1063255024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDIFATAH ABDULLAHI MOHAMED Director 952-492-1031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics |
| Enumeration Date | 2024-06-17 |
| Last Update Date | 2024-06-17 |