NPI | 1801836150 |
---|---|
Entity Type | Organization |
Authorized Contact | RANDY DRAGER CFO 651-698-2406 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA 01898) |
Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: IA F043704) |
Enumeration Date | 2006-06-07 |
Last Update Date | 2024-08-15 |