| NPI | 1144314196 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENISE AILEEN NIEMIRA Sole Proprietor 802-334-6140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VT 42-0005946) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |