Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | 022788 | CT |
NPI | 1467472787 |
---|---|
Provider Name | Susan K Bowers |
First Address | New Haven, CT 06511-2809 |
Second Address | New Haven, CT 06511-2348 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E28864 | (02) | CT |