NPI | 1780098525 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN G. LIETHEN Secretary 952-205-6262 |
Organization Subpart ? | No |
Primary Taxonomy | 208D00000X General Practice |
Additional Taxonomies | 207Q00000X Family Medicine |
207R00000X Internal Medicine | |
Enumeration Date | 2014-06-19 |
Last Update Date | 2019-08-19 |