Individual
MARTA LOPEZ VICENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4160 N 160TH ST, BROOKFIELD, WI 53005-1400
(262) 781-1278
Mailing address
4160 N 160TH ST, BROOKFIELD, WI 53005-1400
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/09/2007
Last updated
06/30/2014
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