| NPI | 1942708508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND S KELLER CFO 651-324-0266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 207QG0300X Family Medicine, Geriatric Medicine | |
| 207RG0300X Internal Medicine, Geriatric Medicine | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-01-30 |
| Last Update Date | 2018-05-17 |