| NPI | 1477318319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADYS AYIERA NDEGE Pmhnp Bc 763-464-6462 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2024-05-21 |