Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0000X | Hematologist | 0420011418 | VT |
NPI | 1427260652 |
---|---|
Provider Name | Dr. Julian Ruffin Sprague |
First Address | South Burlington, VT 05403 |
Second Address | Burlington, VT 05405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2007 |
Last Update Date | 17/12/2019 |