| NPI | 1316228489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORY M BURROUGHS President / Owner 651-209-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MN 1817) |
| Enumeration Date | 2011-09-02 |
| Last Update Date | 2012-09-18 |