| NPI | 1144523622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMUD DAHIR AFGARSHE Medical Director 612-339-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 45178) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2011-11-14 |