NPI | 1073931648 |
---|---|
Entity Type | Organization |
Authorized Contact | IVELISSE AUBIN VIRUET Physician 860-432-5803 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 034410) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2014-04-01 |