| NPI | 1316494032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAIWO REMILEKUN OBAZELUWA-AFOLAYAN Clinical Administrator 763-732-3729 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: MN 377540) |
| Enumeration Date | 2016-09-10 |
| Last Update Date | 2017-01-25 |