| NPI | 1477644490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL MAYNE Business Office Manager 952-832-8143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: MN 7314104) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2025-10-10 |