Individual
K MAE HLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5 SHILOH CT, MADISON, WI 53705-2464
(608) 335-1238
Mailing address
5 SHILOH CT, MADISON, WI 53705-2464
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31128
WI
Other
Enumeration date
02/28/2006
Last updated
07/19/2021
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