Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 6559015 | WI |
NPI | 1083928402 |
---|---|
Provider Name | Dr. Andrea Lin Igowsky |
First Address | Sheboygan, WI 53081-3041 |
Second Address | Sheboygan, WI 53081-3041 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/07/2010 |
Last Update Date | 27/12/2021 |