| NPI | 1295166791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHINASA PAUL ANUGWOM Owner 763-670-5849 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX P6574) |
| Enumeration Date | 2013-12-09 |
| Last Update Date | 2013-12-09 |