Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0000X | Hematologist | 064042 | CT |
N | 207RH0003X | Hematology & Oncology | 064042 | CT |
Y | 207RX0202X | Medical Oncology | 064042 | CT |
N | 207RX0202X | Medical Oncology | 35.130693 | OH |
NPI | 1427344175 |
---|---|
Provider Name | Sope Omowale Olugbile |
First Address | Hartford, CT 06106-2555 |
Second Address | Hartford, CT 06106-2555 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2011 |
Last Update Date | 06/08/2019 |