| NPI | 1073134284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMITOPE ABIOLA DAWODU Provider 612-517-1293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2023-01-20 |