| NPI | 1619341815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA M QUAAK Project Manager 715-330-7090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: WI 47840-20) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2022-12-14 |