Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | 75751 | WI |
N | 2084N0402X | Child Neurologist | 75751 | WI |
NPI | 1225415011 |
---|---|
Provider Name | Amanda Frisosky Abuaf |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792-1005 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/04/2015 |
Last Update Date | 13/09/2021 |