| NPI | 1821387028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD S GUREVICH CEO/President 952-210-8354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MN 5171) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |