| NPI | 1861613010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD E CLEMENT Owner 860-440-3070 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CT 027529) |
| Additional Taxonomies | 174400000X Specialist (Licence: CT 027529) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2010-02-11 |