| NPI | 1144111873 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE WAISBREN Owner/Authorized Official 414-651-0760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-07-11 |
| Last Update Date | 2025-07-14 |