| NPI | 1164573358 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA A MAENPAA Office Manager 414-327-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 01460) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |