| NPI | 1871198465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN BOATENG Sole Member 203-435-7506 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-03-12 |