| NPI | 1871594341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA G NORBY Executive Assistant/Credentialing 763-398-2203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0202X Radiology, Diagnostic Radiology |
| Additional Taxonomies | 2085B0100X Radiology, Body Imaging |
| 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: MN 173) | |
| 2085U0001X Radiology, Diagnostic Ultrasound (Licence: MN 173) | |
| 2085N0700X Radiology, Neuroradiology (Licence: MN 173) | |
| 2085N0904X Radiology, Nuclear Radiology (Licence: MN 173) | |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2014-11-04 |