| NPI | 1932620796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA AHLSTROM Nurse Pracitioner/Owner 612-308-2162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner Gerontology |
| Enumeration Date | 2017-07-03 |
| Last Update Date | 2021-08-31 |