| NPI | 1649391046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT D. CARLSON President 860-429-8439 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: CT 029923) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2011-10-17 |