| NPI | 1134250541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMUND WEST Owner 860-423-8020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 019026) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CT 001754) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-09-06 |