| NPI | 1427079516 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS L ZIMMERMANN Assistant To The President 920-406-9803 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WI 2187-023) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2012-04-19 |