| NPI | 1245590017 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ETHAN DANIEL MEYER President 262-695-6440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 794-025) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |