| NPI | 1356876163 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC A JOHNSON Solo Member 612-423-3238 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: MN 41189) |
| Enumeration Date | 2017-04-29 |
| Last Update Date | 2017-04-29 |