| NPI | 1891247805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNETTA R TROCHE Owner 860-810-2943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CT 005055) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |