NPI | 1104108695 |
---|---|
Entity Type | Organization |
Authorized Contact | MICHAEL JOHN LILLESTOL President 701-232-7705 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R30611) |
Enumeration Date | 2011-09-12 |
Last Update Date | 2011-09-12 |