| NPI | 1225420664 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE K STROOBANTS Credentialing Specialist 920-433-7864 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology |
| Enumeration Date | 2015-02-23 |
| Last Update Date | 2021-10-18 |