| NPI | 1154400034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT KNOX DEMOTT Owner Operator 920-468-3443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VC0200X Obstetrics & Gynecology Critical Care Medicine |
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist Family Health |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2008-07-01 |