| NPI | 1679655377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLIFFORD GLENN MARTIN President/Owner 920-458-4419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: WI 435890) |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |