| NPI | 1366329369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MARTIN Managing Member 414-708-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2025-08-20 |
| Last Update Date | 2025-08-20 |