| NPI | 1306475306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE L VALLEE Authorized Official/Provider 860-483-1074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-07-31 |