| NPI | 1174023907 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIO POWELL Md 414-573-4809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080N0001X Pediatrics, Neonatal-Perinatal Medicine (Licence: WI 46494) |
| Enumeration Date | 2018-02-19 |
| Last Update Date | 2018-02-19 |