| NPI | 1710093968 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA BOBLIN Practice Manager 262-542-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 207T00000X Neurological Surgery |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2017-12-12 |