| NPI | 1679761423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER LARSON Office Manager 860-447-1426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2013-12-12 |