| NPI | 1033696760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA WHITLEY Principal Director 612-701-4301 |
| Organization Subpart ? | No |
| Primary Taxonomy | 364SF0001X Clinical Nurse Specialist Family Health |
| Enumeration Date | 2018-07-25 |
| Last Update Date | 2018-07-25 |