| 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 |