| NPI | 1497935290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE D BOST Office Manager 414-961-0304 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: WI 49399) |
| Enumeration Date | 2007-11-08 |
| Last Update Date | 2019-05-22 |