| NPI | 1699744573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DAVID SUSON Managing Doctor 414-475-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: WI 34950) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: WI 33392) |
| Enumeration Date | 2006-03-14 |
| Last Update Date | 2012-11-12 |