Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 51223-020 | WI |
NPI | 1063573004 |
---|---|
Provider Name | Dr. Christine Marie Hogan |
First Address | Milwaukee, WI 53203-1802 |
Second Address | Milwaukee, WI 53203-1802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 10/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
34986300 | (05) | WI |
H33315 | (02) | NY |