| NPI | 1821453143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ODEGAARD Director Of Business Operations 414-289-3796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: WI 173654-30) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |