Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208800000X | Urologist | 73669 | WI |
Y | 2088P0231X | Pediatric Urologist | 73669 | WI |
NPI | 1053674770 |
---|---|
Provider Name | Dr. Kathryn Trandem |
First Address | Milwaukee, WI 53226-4874 |
Second Address | Milwaukee, WI 53226-4874 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2012 |
Last Update Date | 10/07/2020 |