| NPI | 1427248210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN DAVID WITZKE President 952-893-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: MN 44145) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2007-08-16 |