Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 036061794 | IL |
Y | 207V00000X | Obstetrician & Gynecologist | 23690 | WI |
NPI | 1003923905 |
---|---|
Provider Name | Dr. Joy Zerrudo Seldera |
First Address | Milwaukee, WI 53215-2843 |
Second Address | Lake Geneva, WI 53147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 27/03/2012 |