| NPI | 1891783965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN G POFFENBERGER CFO 952-897-1175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
| 207WX0108X Ophthalmology, Uveitis and Ocular Inflammatory Disease | |
| 207WX0110X Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist | |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2023-10-20 |