| NPI | 1295926129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE A ALDRICH Owner 612-306-2598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R 122978-3) |
| Enumeration Date | 2007-08-06 |
| Last Update Date | 2007-08-06 |