| NPI | 1992176499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORA ELANE SHIRAR Owner 763-267-8701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207RG0300X Internal Medicine, Geriatric Medicine |
| 363L00000X Nurse Practitioner | |
| 363AM0700X Physician Assistant, Medical (Licence: MN 2360) | |
| Enumeration Date | 2015-10-10 |
| Last Update Date | 2025-11-03 |