Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 54118 | WI |
N | 111NI0900X | Internist | 54118 | WI |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 54118 | WI |
NPI | 1093978074 |
---|---|
Provider Name | Hairong Sang |
First Address | Wauwatosa, WI 53226-4216 |
Second Address | Wauwatosa, WI 53226-4216 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 08/05/2013 |