| NPI | 1366551293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY CATHERINE DUNSIRN Executor 920-720-0782 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 23563) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |