| NPI | 1073979951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN LEE SMITH President, Chief Clinical Officer 763-639-5327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R96446-3) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2016-01-08 |