Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 32033 | MN |
NPI | 1003184235 |
---|---|
Provider Name | Kristopher Hartwig |
First Address | Saint Paul, MN 55108-1243 |
Second Address | Minneapolis, MN 55417-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2011 |
Last Update Date | 02/12/2011 |