Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | 54594 | CT |
NPI | 1023324555 |
---|---|
Provider Name | Ankit Gupta |
First Address | Norwich, CT 06360-2700 |
Second Address | Norwich, CT 06360-2700 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2010 |
Last Update Date | 07/04/2021 |