Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 51460 | MN |
Y | 207VX0201X | Gynecologic Oncologist | 51460 | MN |
NPI | 1225158132 |
---|---|
Provider Name | Boris Jan Nils Winterhoff |
First Address | Minneapolis, MN 55455-0341 |
Second Address | Minneapolis, MN 55455-0341 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 15/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
ENROLLED | (05) | MN |