| NPI | 1558795914 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD L LONDON Sole Member 414-375-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine (Licence: WI 26420) |
| Enumeration Date | 2013-08-21 |
| Last Update Date | 2013-08-21 |