| NPI | 1255951190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLI BROWN Office Manager 612-322-6905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics Neonatal-Perinatal Medicine |
| Additional Taxonomies | 363LN0000X Nurse Practitioner Neonatal |
| 363AM0700X Physician Assistant Medical | |
| Enumeration Date | 2020-04-21 |
| Last Update Date | 2024-08-02 |