Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 294552 | NY |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 55808 | CT |
NPI | 1558704106 |
---|---|
Provider Name | Michael Gabriel |
First Address | Nashville, TN 37201-1835 |
Second Address | New Haven, CT 06510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/04/2013 |
Last Update Date | 23/07/2018 |