| NPI | 1447204433 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE YOUNG Business Manager 952-401-8290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2012-12-20 |