| NPI | 1376359521 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL TABAKIN President 414-617-9941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2024-12-03 |
| Last Update Date | 2025-08-25 |