| NPI | 1457304446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND S KELLER CFO 651-324-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine Geriatric Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207R00000X Internal Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LG0600X Nurse Practitioner Gerontology | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-09-26 |