| NPI | 1295454874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZILLAH KEMUNTO MULUBISHA Clinical Director 763-639-7501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2026-06-23 |