| NPI | 1972043503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA K PARISH Nurse Practitioner 414-745-4569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2022-06-21 |