| NPI | 1073257465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JOHN WITHERS Owner, Authorized Official 414-708-7465 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2022-04-22 |