NPI | 1760540397 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY J MARTIN Office Manager 860-889-3841 |
Organization Subpart ? | No |
Primary Taxonomy | 208600000X Surgery (Licence: CT 016369) |
Additional Taxonomies | 208600000X Surgery (Licence: CT 030790) |
Enumeration Date | 2006-12-05 |
Last Update Date | 2007-08-02 |