| NPI | 1689095051 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERYL LANDWEHR Manager 952-801-0415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 1336125111) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2014-01-02 |