| NPI | 1427612100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY DANIELLE HOLMES Owner, Nurse Practitioner 203-701-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health |
| Additional Taxonomies | 207RG0300X Internal Medicine Geriatric Medicine |
| Enumeration Date | 2019-04-28 |
| Last Update Date | 2019-05-16 |