Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175F00000X | Naturopath | 000210 | CT |
NPI | 1134280720 |
---|---|
Provider Name | Dr. Vaughn Bowman |
First Address | Norwalk, CT 06851-2210 |
Second Address | Norwalk, CT 06851-2210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 08/07/2007 |