Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0200X | Infectious Disease | R6582 | MO |
Y | 2080P0208X | Pediatric Infectious Diseases | 030377 | CT |
NPI | 1568617918 |
---|---|
Provider Name | Dr. Lisa M Dunkle |
First Address | Madison, CT 06443-2530 |
Second Address | Madison, CT 06443-2530 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2008 |
Last Update Date | 02/09/2015 |