| NPI | 1174886188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISON JOAN GORMAN Owner 860-670-3039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 004196) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-07-24 |