| NPI | 1376598235 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL DEI President 414-831-0512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: WI 575-025) |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2008-02-29 |