| NPI | 1356085104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AWAIS SIDDIQUE Owner 262-577-0250 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Additional Taxonomies | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2022-04-26 |
| Last Update Date | 2022-04-26 |