| NPI | 1346257185 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSELITO BAYLON President 262-352-9081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 36046) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: WI 33957) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2020-08-22 |