| NPI | 1194437061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LARBI-ODAM Medical Director 952-228-0420 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| 207RR0500X Internal Medicine, Rheumatology | |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2084P0800X Psychiatry & Neurology, Psychiatry | |
| 207K00000X Allergy & Immunology | |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| Enumeration Date | 2022-12-21 |
| Last Update Date | 2023-03-31 |