| NPI | 1760537013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM H HERNANDEZ Owner 860-889-1400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CT 207Q00000X) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 005383) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2013-12-03 |