| NPI | 1730889882 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MULUH FONGWI FONGWI LADUNA FONDONG Partner 218-779-9437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2023-03-07 |
| Last Update Date | 2023-03-07 |