| NPI | 1073666269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIMITRIOS P BOUSOUNIS Owner 414-964-8450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: WI 27172) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2008-04-24 |