Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | 52952-20 | WI |
NPI | 1003935925 |
---|---|
Provider Name | Andrea Michelle Kraus |
First Address | Milwaukee, WI 53226-2315 |
Second Address | Milwaukee, WI 53215-4526 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 07/04/2017 |