| NPI | 1144745951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON WOLFF Owner 763-201-8191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2020-01-28 |