Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 001230 | CT |
NPI | 1497061584 |
---|---|
Provider Name | Dr. David Norman Dube |
First Address | Milford, CT 06460-2677 |
Second Address | Milford, CT 06460-2677 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2010 |
Last Update Date | 26/08/2010 |