| NPI | 1184897472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAO XIONG THAO Authorized Official 414-908-6506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2008-04-08 |
| Last Update Date | 2025-01-08 |