Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 18475 | MN |
NPI | 1457508319 |
---|---|
Provider Name | Dr. Laurence Edward Winter |
First Address | Loretto, MN 55357-9590 |
Second Address | Loretto, MN 55357-9590 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/08/2008 |
Last Update Date | 22/08/2008 |