| NPI | 1043474315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIO LUIS ILADA President 262-598-9205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 35992-020) |
| Enumeration Date | 2008-07-15 |
| Last Update Date | 2008-07-15 |