| NPI | 1134314362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILSON H LUY TAN President 920-887-3460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: WI 28716-020) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2007-09-11 |