| NPI | 1730156274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD H THOLEN President 763-545-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 788) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2020-08-22 |