| NPI | 1346326196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AUDREY IRENE BERG Business Office Supervisor 763-383-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 360) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2009-01-22 |