| NPI | 1306283718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES CAVO Owner 860-906-1732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: CT 042274) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CT 042274) |
| 363L00000X Nurse Practitioner (Licence: CT 042274) | |
| Enumeration Date | 2013-05-24 |
| Last Update Date | 2015-08-25 |