Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 25MA04022200 | NJ |
NPI | 1073532842 |
---|---|
Provider Name | Dr. Bruno Nathaniel Latunde' Cole |
First Address | Princeton, NJ 08540-6331 |
Second Address | Princeton, NJ 08540-6331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6398804 | (05) | NJ |
E53213 | (02) | NJ |