| NPI | 1982803102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE SURA Office Manager 414-453-7780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology Neurology (Licence: WI 19841) |
| Enumeration Date | 2007-07-17 |
| Last Update Date | 2019-01-08 |