Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 62569-20 | WI |
NPI | 1003109794 |
---|---|
Provider Name | Dr. Zainab Kagen |
First Address | Oshkosh, WI 54904-7247 |
Second Address | Oshkosh, WI 54904-7247 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2011 |
Last Update Date | 29/10/2021 |