| NPI | 1629475371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE M MACKIE Financial Officer 860-425-8755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LN0005X Nurse Practitioner, Neonatal, Critical Care |
| Enumeration Date | 2014-11-24 |
| Last Update Date | 2014-11-24 |