| NPI | 1629287792 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY SUE POPHAM Owner 218-249-6230 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology (Licence: MN 35304) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |