| NPI | 1932597002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID A PAULSON Medical Director 612-390-4747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MN R172606-6) |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2015-03-31 |