| NPI | 1437459211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RADHA KRISHNA KUMAR Owner 952-944-6989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207QA0505X Family Medicine, Adult Medicine | |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-28 |