| NPI | 1659062099 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE BALLET Executive VP 860-771-0622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2023-05-17 |
| Last Update Date | 2023-08-11 |