| NPI | 1932308186 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHRAM NAMDARI Owner 414-282-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 19858020) |
| Additional Taxonomies | 2086S0129X (Licence: WI 19858020) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2007-07-17 |