| NPI | 1871318584 |
|---|---|
| Doing Business As | EDELICA |
| Entity Type | Organization |
| Authorized Contact | KEVIN KANE President 414-206-1606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 363LF0000X Nurse Practitioner, Family | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health | |
| Enumeration Date | 2024-11-18 |
| Last Update Date | 2024-11-18 |