NPI | 1053690917 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY DRAGER CFO 651-698-2406 |
Organization Subpart ? | No |
Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: IA 33019) |
Enumeration Date | 2011-08-10 |
Last Update Date | 2024-08-15 |