| NPI | 1538917737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN ROBERT BYRNE Organizer 414-426-6332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 2084S0010X Psychiatry & Neurology, Sports Medicine | |
| Enumeration Date | 2024-05-11 |
| Last Update Date | 2024-05-11 |