| NPI | 1720105877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN D. GLASSMAN Doctor 414-444-9811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: WI 1653) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 1998) |
| 103T00000X Psychologist (Licence: WI 1653) | |
| 103T00000X Psychologist (Licence: WI 1998) | |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2010-01-29 |