| NPI | 1932605318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN T. MICHAELSON Ap RN 860-263-3603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CT 003107) |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2018-04-03 |