Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 20150 | CT |
NPI | 1053489864 |
---|---|
Provider Name | Lauren Daman |
First Address | Hartford, CT 06106-2528 |
Second Address | Hartford, CT 06106-2528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 18/08/2010 |