NPI | 1134274921 |
---|---|
Entity Type | Organization |
Authorized Contact | ANNA LIS Billing 860-721-9444 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: CT 035532) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 6599) |
Enumeration Date | 2007-01-24 |
Last Update Date | 2016-10-19 |