Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 412285 | CT |
NPI | 1396814174 |
---|---|
Provider Name | Lawrence Engmann |
First Address | Hartford, CT 06106-2528 |
Second Address | Hartford, CT 06106-2528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2006 |
Last Update Date | 14/03/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05690680 | ECFMG NUMBER (01) |