| NPI | 1457437907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILLICENT WANJOHI Physician Assistant 763-571-9361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MN 935) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |