| NPI | 1073694618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WADE Director Of Finance 414-465-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RS0010X Internal Medicine, Sports Medicine | |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |