| NPI | 1609389675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADEPERO OLUFUNMILAYO OKULAJA Owner 612-836-9412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN 49342) |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2017-12-29 |