| NPI | 1790964435 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT PURTOCK President 262-787-4026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: WI 23846-20) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: WI 23846-20) |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: WI 23846) | |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2007-10-30 |