| NPI | 1174876643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFONSO MORALES-UTRILLA Medical Director 651-644-6002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: MN 37899) |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2013-11-01 |