| NPI | 1174633119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK GERHARD EBERHAGE President 414-259-3900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |