204C00000X
Bloomington, MN
Specialty
204C00000X
Credential
ATC
NPI
1184148017
8100 Northland Dr, Bloomington, MN 55431
(952) 831-8742Confirm current license and practice information on the official CMS NPI registry.
View NPI RecordThis surgeon specializes in 204c00000x procedures performed in an outpatient ambulatory surgical setting.
NUCC Taxonomy: 204C00000X