| NPI | 1578510632 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFERY ENTRESS Authorized Official 262-544-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2010-12-09 |