| NPI | 1235503269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROR O HULTGREN CEO 952-936-6125 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 363A00000X Physician Assistant | |
| 171M00000X Case Manager/Care Coordinator | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2015-11-13 |
| Last Update Date | 2015-11-16 |