| NPI | 1912786567 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SUSAN GOEHL-MANOLIS Nurse Practitioner/Owner 952-300-3016 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health | 
| Enumeration Date | 2023-09-25 | 
| Last Update Date | 2023-09-25 |