| NPI | 1972126837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER PRIMAKOW Administrative Assistant 608-516-1956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2024-10-08 |