NPI | 1982150728 |
---|---|
Entity Type | Organization |
Authorized Contact | SOFIYA TSUKERMAN Htcp 763-494-4686 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: MN L 48617-4) |
Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MN L 48617-4) |
Enumeration Date | 2016-08-31 |
Last Update Date | 2016-08-31 |