| NPI | 1386738672 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOE LOUIE CHIN President 920-206-7772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: WI 21633) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |