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1780333567
DEEMANTHA GAYAN FERNANDO WIJEKULASOORIYAGE
MILWAUKEE, WI
NPI
1780333567
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-03-21
Last Update Date
2022-03-21
Business Address
DEEMANTHA GAYAN FERNANDO WIJEKULASOORIYAGE MD
945 N 12TH ST
MILWAUKEE, WI 53233-1305
Phone number: 414-219-5725
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Mailing Address
DEEMANTHA GAYAN FERNANDO WIJEKULASOORIYAGE MD
945 N 12TH ST
MILWAUKEE, WI 53233-1305
Phone number: 414-219-5725
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