Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist |
NPI | 1871646901 |
---|---|
Provider Name | Dr. Martin K. Oaks |
First Address | Muskego, WI 53150-8599 |
Second Address | Milwaukee, WI 53215-4330 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2007 |
Last Update Date | 08/07/2007 |