| NPI | 1225118342 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALI ABDI JAMA Presiden 612-871-6328 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MN 329379) |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2011-12-08 |