NPI | 1174633119 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK GERHARD EBERHAGE President 414-259-3900 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 103T00000X Psychologist |
Enumeration Date | 2006-08-30 |
Last Update Date | 2025-09-11 |