Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | 091-0000017 | VT |
NPI | 1952519423 |
---|---|
Provider Name | Julian Jonas |
First Address | Brattleboro, VT 05301-6222 |
Second Address | Brattleboro, VT 05301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/05/2007 |
Last Update Date | 08/07/2007 |