| NPI | 1497024640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MUELLER Owner 612-518-5527 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 685) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY 422) |
| Enumeration Date | 2011-12-16 |
| Last Update Date | 2011-12-16 |