| NPI | 1841243839 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE S. AGPOON President 262-544-9680 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: WI 18704) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |