| NPI | 1558054791 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREG TAKENISHI Chief Excecutive Officer 414-807-0645 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2023-06-01 |