| NPI | 1952131872 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS M ONDARA Owner 763-898-2157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |