Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0002X | Hospice and Palliative Medicine | 51686 | WI |
Y | 207RX0202X | Medical Oncology | 51686 | WI |
NPI | 1164518692 |
---|---|
Provider Name | Dr. Justine Yang Bruce |
First Address | Middleton, WI 53562-5531 |
Second Address | Madison, WI 53792 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 28/01/2021 |