| NPI | 1942257647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRIMITIVO I REYNALDO Authorized Official 414-302-9196 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2025-09-11 |