| NPI | 1497756977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207V00000X Obstetrics & Gynecology | |
| 208000000X Pediatrics | |
| 2080P0006X Pediatrics Developmental - Behavioral Pediatrics | |
| 2085R0202X Radiology Diagnostic Radiology | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2019-08-19 |