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1134198005
KITIMA BOONVISUDHI
MILWAUKEE, WI
NPI
1134198005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
208600000X Surgery
(Licence: WI 59966)
Additional Taxonomies
208600000X Surgery
(Licence: NY 204411)
Enumeration Date
2006-03-14
Last Update Date
2013-01-30
Business Address
Dr. KITIMA BOONVISUDHI
2901 W KINNICKINNIC RIVER PKWY STE 311
MILWAUKEE, WI 53215-3677
Phone number: 414-385-8723
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Mailing Address
Dr. KITIMA BOONVISUDHI
2901 W KINNICKINNIC RIVER PKWY STE 311
MILWAUKEE, WI 53215-3677
Phone number: 414-385-8723
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