| NPI | 1114214350 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT MCMANUS M.D. 414-271-5119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: WI 2780-23) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2011-07-08 |