| NPI | 1952420382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICHOLE A HOLZEM Business Office Manager 920-432-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |