| NPI | 1154402576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY WADE Director Of Finance 414-465-3000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2020-08-22 |