| NPI | 1043415631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANESH N PULLA Doctor 262-564-8636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 207RN0300X Internal Medicine, Nephrology |
| Enumeration Date | 2007-06-15 |
| Last Update Date | 2007-10-05 |