NPI | 1003001850 |
---|---|
Entity Type | Organization |
Authorized Contact | ROY MARTIN MAIN Owner/Physician 860-536-1666 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 031865) |
Enumeration Date | 2007-09-13 |
Last Update Date | 2007-09-13 |