| NPI | 1639402365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY ANN COUCH Executive Administrative Assistant 262-754-3613 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease |
| 207RI0011X Internal Medicine, Interventional Cardiology | |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2015-09-15 |