| NPI | 1679885164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHY KAYE MATSON Manager 651-290-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 37988) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-07-13 |