| NPI | 1760761183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID G DAI Owner 414-476-8388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: WI 132-055) |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2011-08-16 |