| NPI | 1033489984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY HABEEB Credentials Coordinator 860-425-8715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: CT 4880) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2012-01-10 |