| NPI | 1306164512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMER L VALIN Owner 203-867-5518 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 032798) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 032798) |
| 363L00000X Nurse Practitioner (Licence: CT 003133) | |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2011-12-13 |