| NPI | 1447019310 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA FITCH President 952-237-5489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
| 207RB0002X Internal Medicine, Bariatric Medicine | |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| Enumeration Date | 2024-03-14 |
| Last Update Date | 2024-03-14 |