| NPI | 1477599918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHY WASSON Systems Manager/Security Officer 952-997-9313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 723) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2018-06-11 |