| NPI | 1881085793 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARREN MATAVKA Vice President 414-376-5577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
| 363A00000X Physician Assistant | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2015-02-13 |
| Last Update Date | 2015-02-13 |