Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 63941 | WI |
NPI | 1356517122 |
---|---|
Provider Name | Jayme Susan Bosler |
First Address | Menomonee Falls, WI 53051-0538 |
Second Address | Menomonee Falls, WI 53051-0538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 11/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1356517122 | (05) | WI |