| NPI | 1962580274 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOSSIA MILLER LAKE Clinic Operations Coordinator 612-813-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0202X Pediatrics, Pediatric Cardiology |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2012-10-16 |