| NPI | 1518147297 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDY DRAGER CFO 651-698-2406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2024-08-15 |