| NPI | 1669910345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAHTAB SIDHU Medical Director 262-875-5070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2017-02-02 |
| Last Update Date | 2023-09-11 |