| NPI | 1659494961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATIE L WITSCHEN Office Manager 952-767-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MN 36061) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2012-04-02 |