| NPI | 1548575434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER A CARPENTER Owner / President 651-287-8780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2010-08-16 |