Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 75505-20 | WI |
N | 2080N0001X | Neonatal-Perinatal Doctor | 75505-20 | WI |
NPI | 1124522651 |
---|---|
Provider Name | Oresta Rule |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53715-1507 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2018 |
Last Update Date | 07/10/2021 |