| NPI | 1063162329 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA JOYCE Physician Assistant 860-303-0706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2022-03-28 |
| Last Update Date | 2022-03-28 |