| NPI | 1144223009 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA COOMBE Business Administrator 763-525-0363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZD0900X Pathology, Dermatopathology (Licence: MN 1279) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2024-09-16 |