| NPI | 1205240686 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK LAVORA Podiatrist 414-768-5430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 178111-30) |
| Enumeration Date | 2014-06-13 |
| Last Update Date | 2014-06-13 |