| NPI | 1104322023 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC CHURCH Member 414-982-5977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: AZ 48629) |
| Enumeration Date | 2018-03-30 |
| Last Update Date | 2018-03-30 |