| NPI | 1679546584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM M BEDUZE Office Administrator 262-567-1499 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2008-01-30 |