| NPI | 1003968157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J. IWANICKI Owner 603-275-3892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 2086S0127X Surgery Trauma Surgery |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2011-10-14 |