| NPI | 1265621874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSIE BRUESKE Office Manager 612-333-9954 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 9076412) |
| Enumeration Date | 2007-10-19 |
| Last Update Date | 2007-10-19 |