Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208G00000X | Cardiothoracic Vascular Surgeon | 011070 | CT |
NPI | 1124384276 |
---|---|
Provider Name | Dr. Louis Brown |
First Address | West Hartford, CT 06117 |
Second Address | West Hartford, CT 06117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2012 |
Last Update Date | 03/04/2012 |