| NPI | 1295454874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZILLAH K MULUBISHA Nurse Practitioner 763-298-3159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| Enumeration Date | 2022-08-25 |
| Last Update Date | 2024-11-04 |