| NPI | 1730399379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILA EBRAHIMKHIL Office Manager 860-228-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| 363LP0200X Nurse Practitioner, Pediatrics | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2013-12-03 |